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Synopses

Medscape CME Activity
Infant Botulism, Israel, 2007–2021 [PDF - 463 KB - 7 pages]
B. Goldberg et al.

Infant botulism (IB) is an intestinal toxemia that manifests as descending paralysis, constipation, and, in some cases, respiratory failure. Laboratory-confirmed IB cases are rare, and recent data in Israel are lacking. We conducted a national multicenter retrospective study of laboratory-confirmed IB cases reported in Israel during 2007–2021. A total of 8 cases were reported during the study period. During 2019–2021, incidence may have increased because of a cluster of 5 cases. Infant median age for diagnosis was 6.5 months, older than previously reported (3 months). Most cases occurred during March–July. Honey consumption was reported in 1 case, and possible environmental risk factors (living nearby rural or construction areas, dust exposure, and having a father who works as a farmer) were reported in 6 cases. Although IB is rare, its incidence in Israel may have increased over recent years, and its epidemiology and risk factors differ from cases reported previously in Israel.

EID Goldberg B, Danino D, Levinsky Y, Levy I, Straussberg R, Dabaja-Younis H, et al. Infant Botulism, Israel, 2007–2021. Emerg Infect Dis. 2023;29(2):235-241. https://doi.org/10.3201/eid2902.220991
AMA Goldberg B, Danino D, Levinsky Y, et al. Infant Botulism, Israel, 2007–2021. Emerging Infectious Diseases. 2023;29(2):235-241. doi:10.3201/eid2902.220991.
APA Goldberg, B., Danino, D., Levinsky, Y., Levy, I., Straussberg, R., Dabaja-Younis, H....Scheuerman, O. (2023). Infant Botulism, Israel, 2007–2021. Emerging Infectious Diseases, 29(2), 235-241. https://doi.org/10.3201/eid2902.220991.

Sentinel Surveillance System Implementation and Evaluation for SARS-CoV-2 Genomic Data, Washington, USA, 2020–2021 [PDF - 2.32 MB - 10 pages]
H. N. Oltean et al.

Genomic data provides useful information for public health practice, particularly when combined with epidemiologic data. However, sampling bias is a concern because inferences from nonrandom data can be misleading. In March 2021, the Washington State Department of Health, USA, partnered with submitting and sequencing laboratories to establish sentinel surveillance for SARS-CoV-2 genomic data. We analyzed available genomic and epidemiologic data during presentinel and sentinel periods to assess representativeness and timeliness of availability. Genomic data during the presentinel period was largely unrepresentative of all COVID-19 cases. Data available during the sentinel period improved representativeness for age, death from COVID-19, outbreak association, long-term care facility–affiliated status, and geographic coverage; timeliness of data availability and captured viral diversity also improved. Hospitalized cases were underrepresented, indicating a need to increase inpatient sampling. Our analysis emphasizes the need to understand and quantify sampling bias in phylogenetic studies and continue evaluation and improvement of public health surveillance systems.

EID Oltean HN, Allen KJ, Frisbie L, Lunn SM, Torres L, Manahan L, et al. Sentinel Surveillance System Implementation and Evaluation for SARS-CoV-2 Genomic Data, Washington, USA, 2020–2021. Emerg Infect Dis. 2023;29(2):242-251. https://doi.org/10.3201/eid2902.221482
AMA Oltean HN, Allen KJ, Frisbie L, et al. Sentinel Surveillance System Implementation and Evaluation for SARS-CoV-2 Genomic Data, Washington, USA, 2020–2021. Emerging Infectious Diseases. 2023;29(2):242-251. doi:10.3201/eid2902.221482.
APA Oltean, H. N., Allen, K. J., Frisbie, L., Lunn, S. M., Torres, L., Manahan, L....Lindquist, S. (2023). Sentinel Surveillance System Implementation and Evaluation for SARS-CoV-2 Genomic Data, Washington, USA, 2020–2021. Emerging Infectious Diseases, 29(2), 242-251. https://doi.org/10.3201/eid2902.221482.

Medscape CME Activity
Crimean-Congo Hemorrhagic Fever, Spain, 2013–2021 [PDF - 2.14 MB - 8 pages]
H. Lorenzo Juanes et al.

Crimean-Congo hemorrhagic fever (CCHF) is a viral infectious disease for which distribution of the main vector, Hyalomma spp. ticks, is expanding. We analyzed all 10 cases of CCHF diagnosed in Spain during 2013–2021; case-patient median age was 56.5 years, and 7 were men. We identified CCHF virus genotypes III and V. Six case-patients acquired the infection in urban areas. Sixty percent of patients were infected in summer and 40% in spring. Two patients met criteria for hemophagocytic syndrome. Seven patients survived. The epidemiologic pattern of CCHF in Spain is based on occasional cases with an elevated mortality rate. Genotype III and, to a less extent also genotype V, CCHF circulates in humans in a common geographic area in Spain. Those data suggest that the expansion pathways are complex and may change over time. Physicians should remain alert to the possibility of new CCHF cases.

EID Lorenzo Juanes H, Carbonell C, Sendra B, López-Bernus A, Bahamonde A, Orfao A, et al. Crimean-Congo Hemorrhagic Fever, Spain, 2013–2021. Emerg Infect Dis. 2023;29(2):252-259. https://doi.org/10.3201/eid2902.220677
AMA Lorenzo Juanes H, Carbonell C, Sendra B, et al. Crimean-Congo Hemorrhagic Fever, Spain, 2013–2021. Emerging Infectious Diseases. 2023;29(2):252-259. doi:10.3201/eid2902.220677.
APA Lorenzo Juanes, H., Carbonell, C., Sendra, B., López-Bernus, A., Bahamonde, A., Orfao, A....Belhassen-García, M. (2023). Crimean-Congo Hemorrhagic Fever, Spain, 2013–2021. Emerging Infectious Diseases, 29(2), 252-259. https://doi.org/10.3201/eid2902.220677.

Streptococcus dysgalactiae Bloodstream Infections, Norway, 1999–2021 [PDF - 2.52 MB - 8 pages]
O. Oppegaard et al.

Streptococcus dysgalactiae increasingly is recognized as a pathogen of concern for human health. However, longitudinal surveillance data describing temporal trends of S. dysgalactiae are scarce. We retrospectively identified all β-hemolytic streptococcal bloodstream infections reported in Bergen, in western Norway, during 1999–2021. To explore S. dysgalactiae disease burden in a broader context, we mapped the incidence of all microbial species causing bloodstream infections during 2012–2021. We found S. dysgalactiae incidence rates substantially increased during the study period; by 2021, S. dysgalactiae was the fifth most common pathogen causing bloodstream infections in our region. We noted genotypic shifts and found that the rising trend was related in part to the introduction and expansion of the stG62647 emm-type. S. dysgalactiae is among the most common causes of bloodstream infections in western Norway, and increased surveillance and unambiguous species identification are needed to monitor the disease burden attributable to this pathogen.

EID Oppegaard O, Glambek M, Skutlaberg D, Skrede S, Sivertsen A, Kittang B. Streptococcus dysgalactiae Bloodstream Infections, Norway, 1999–2021. Emerg Infect Dis. 2023;29(2):260-267. https://doi.org/10.3201/eid2902.221218
AMA Oppegaard O, Glambek M, Skutlaberg D, et al. Streptococcus dysgalactiae Bloodstream Infections, Norway, 1999–2021. Emerging Infectious Diseases. 2023;29(2):260-267. doi:10.3201/eid2902.221218.
APA Oppegaard, O., Glambek, M., Skutlaberg, D., Skrede, S., Sivertsen, A., & Kittang, B. (2023). Streptococcus dysgalactiae Bloodstream Infections, Norway, 1999–2021. Emerging Infectious Diseases, 29(2), 260-267. https://doi.org/10.3201/eid2902.221218.

Changing Disease Course of Crimean-Congo Hemorrhagic Fever in Children, Turkey [PDF - 1.26 MB - 10 pages]
P. Oygar et al.

Crimean-Congo hemorrhagic fever (CCHF), endemic in certain regions of the world, is listed as a priority disease with pandemic potential. Since CCHF was first identified in Turkey, children have been known to experience milder disease than adults. However, during the COVID-19 pandemic, we observed an unusually severe disease course, including hemophagocytic lymphohistiocytosis (HLH). We examined cytokine/chemokine profiles of 9/12 case-patients compared with healthy controls at 3 time intervals. Interferon pathway–related cytokines/chemokines, including interleukin (IL) 18, macrophage inflammatory protein 3α, and IL-33, were elevated, but tumor necrosis factor-α, IL-6, CXCL8 (formerly IL-8), and cytokines acting through C-C chemokine receptor 2 and CCR5 were lower among case-patients than controls. Interferon pathway activation and cytokines/chemokines acting through CCR2 and CCR5 improved health results among children with severe CCHF. Children can experience severe CCHF, including HLH, and HLH secondary to CCHF can be successfully treated with intravenous immunoglobulin and steroid therapy.

EID Oygar P, Gürlevik S, Sağ E, İlbay S, Aksu T, Demir O, et al. Changing Disease Course of Crimean-Congo Hemorrhagic Fever in Children, Turkey. Emerg Infect Dis. 2023;29(2):268-277. https://doi.org/10.3201/eid2902.220976
AMA Oygar P, Gürlevik S, Sağ E, et al. Changing Disease Course of Crimean-Congo Hemorrhagic Fever in Children, Turkey. Emerging Infectious Diseases. 2023;29(2):268-277. doi:10.3201/eid2902.220976.
APA Oygar, P., Gürlevik, S., Sağ, E., İlbay, S., Aksu, T., Demir, O....Özsürekci, Y. (2023). Changing Disease Course of Crimean-Congo Hemorrhagic Fever in Children, Turkey. Emerging Infectious Diseases, 29(2), 268-277. https://doi.org/10.3201/eid2902.220976.
Research

Relationship between Telework Experience and Presenteeism during COVID-19 Pandemic, United States, March–November 2020 [PDF - 1.01 MB - 8 pages]
L. Shafer et al.

Persons with COVID-19–like illnesses are advised to stay home to reduce the spread of SARS-CoV-2. We assessed relationships between telework experience and COVID-19 illness with work attendance when ill. Adults experiencing fever, cough, or loss of taste or smell who sought healthcare or COVID-19 testing in the United States during March–November 2020 were enrolled. Adults with telework experience before illness were more likely to work at all (onsite or remotely) during illness (87.8%) than those with no telework experience (49.9%) (adjusted odds ratio 5.48, 95% CI 3.40–8.83). COVID-19 case-patients were less likely to work onsite (22.1%) than were persons with other acute respiratory illnesses (37.3%) (adjusted odds ratio 0.36, 95% CI 0.24–0.53). Among COVID-19 case-patients with telework experience, only 6.5% worked onsite during illness. Telework experience before illness gave mildly ill workers the option to work and improved compliance with public health recommendations to stay home during illness.

EID Shafer L, Ahmed F, Kim S, Wernli KJ, Jackson ML, Nowalk M, et al. Relationship between Telework Experience and Presenteeism during COVID-19 Pandemic, United States, March–November 2020. Emerg Infect Dis. 2023;29(2):278-285. https://doi.org/10.3201/eid2902.221014
AMA Shafer L, Ahmed F, Kim S, et al. Relationship between Telework Experience and Presenteeism during COVID-19 Pandemic, United States, March–November 2020. Emerging Infectious Diseases. 2023;29(2):278-285. doi:10.3201/eid2902.221014.
APA Shafer, L., Ahmed, F., Kim, S., Wernli, K. J., Jackson, M. L., Nowalk, M....Uzicanin, A. (2023). Relationship between Telework Experience and Presenteeism during COVID-19 Pandemic, United States, March–November 2020. Emerging Infectious Diseases, 29(2), 278-285. https://doi.org/10.3201/eid2902.221014.

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France [PDF - 2.54 MB - 8 pages]
P. Pérot et al.

In March 2022, a 61-year-old woman in France who had received a heart-lung transplant sought treatment with chronic hepatitis mainly characterized by increased liver enzymes. After ruling out common etiologies, we used metagenomic next-generation sequencing to analyze a liver biopsy sample and identified an unknown species of circovirus, tentatively named human circovirus 1 (HCirV-1). We found no other viral or bacterial sequences. HCirV-1 shared 70% amino acid identity with the closest known viral sequences. The viral genome was undetectable in blood samples from 2017–2019, then became detectable at low levels in September 2020 and peaked at very high titers (1010 genome copies/mL) in January 2022. In March 2022, we found >108 genome copies/g or mL in the liver and blood, concomitant with hepatic cytolysis. We detected HCirV-1 transcripts in 2% of hepatocytes, demonstrating viral replication and supporting the role of HCirV-1 in liver damage.

EID Pérot P, Fourgeaud J, Rouzaud C, Regnault B, Da Rocha N, Fontaine H, et al. Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France. Emerg Infect Dis. 2023;29(2):286-293. https://doi.org/10.3201/eid2902.221468
AMA Pérot P, Fourgeaud J, Rouzaud C, et al. Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France. Emerging Infectious Diseases. 2023;29(2):286-293. doi:10.3201/eid2902.221468.
APA Pérot, P., Fourgeaud, J., Rouzaud, C., Regnault, B., Da Rocha, N., Fontaine, H....Eloit, M. (2023). Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France. Emerging Infectious Diseases, 29(2), 286-293. https://doi.org/10.3201/eid2902.221468.

Incidence and Transmission Dynamics of Bordetella pertussis Infection in Rural and Urban Communities, South Africa, 2016‒2018 [PDF - 670 KB - 10 pages]
F. Moosa et al.

We conducted 3 prospective cohort studies (2016–2018), enrolling persons from 2 communities in South Africa. Nasopharyngeal swab specimens were collected twice a week from participants. Factors associated with Bordetella pertussis incidence, episode duration, and household transmission were determined by using Poisson regression, Weibull accelerated time-failure, and logistic regression hierarchical models, respectively. Among 1,684 participants, 118 episodes of infection were detected in 107 participants (incidence 0.21, 95% CI 0.17–0.25 infections/100 person-weeks). Children <5 years of age who had incomplete vaccination were more likely to have pertussis infection. Episode duration was longer for participants who had higher bacterial loads. Transmission was more likely to occur from male index case-patients and persons who had >7 days infection duration. In both communities, there was high incidence of B. pertussis infection and most cases were colonized.

EID Moosa F, Tempia S, Kleynhans J, McMorrow M, Moyes J, du Plessis M, et al. Incidence and Transmission Dynamics of Bordetella pertussis Infection in Rural and Urban Communities, South Africa, 2016‒2018. Emerg Infect Dis. 2023;29(2):294-303. https://doi.org/10.3201/eid2902.221125
AMA Moosa F, Tempia S, Kleynhans J, et al. Incidence and Transmission Dynamics of Bordetella pertussis Infection in Rural and Urban Communities, South Africa, 2016‒2018. Emerging Infectious Diseases. 2023;29(2):294-303. doi:10.3201/eid2902.221125.
APA Moosa, F., Tempia, S., Kleynhans, J., McMorrow, M., Moyes, J., du Plessis, M....Wolter, N. (2023). Incidence and Transmission Dynamics of Bordetella pertussis Infection in Rural and Urban Communities, South Africa, 2016‒2018. Emerging Infectious Diseases, 29(2), 294-303. https://doi.org/10.3201/eid2902.221125.

Influence of Landscape Patterns on Exposure to Lassa Fever Virus, Guinea [PDF - 3.03 MB - 10 pages]
S. Longet et al.

Lassa fever virus (LASV) is the causative agent of Lassa fever, a disease endemic in West Africa. Exploring the relationships between environmental factors and LASV transmission across ecologically diverse regions can provide crucial information for the design of appropriate interventions and disease monitoring. We investigated LASV exposure in 2 ecologically diverse regions of Guinea. Our results showed that exposure to LASV was heterogenous between and within sites. LASV IgG seropositivity was 11.9% (95% CI 9.7%–14.5%) in a coastal study site in Basse-Guinée, but it was 59.6% (95% CI 55.5%–63.5%) in a forested study site located in Guinée Forestière. Seropositivity increased with age in the coastal site. We also found significant associations between exposure risk for LASV and landscape fragmentation in coastal and forested regions. Our study highlights the potential link between environmental change and LASV emergence and the urgent need for research on land management practices that reduce disease risks.

EID Longet S, Leggio C, Bore J, Key S, Tipton T, Hall Y, et al. Influence of Landscape Patterns on Exposure to Lassa Fever Virus, Guinea. Emerg Infect Dis. 2023;29(2):304-313. https://doi.org/10.3201/eid2902.212525
AMA Longet S, Leggio C, Bore J, et al. Influence of Landscape Patterns on Exposure to Lassa Fever Virus, Guinea. Emerging Infectious Diseases. 2023;29(2):304-313. doi:10.3201/eid2902.212525.
APA Longet, S., Leggio, C., Bore, J., Key, S., Tipton, T., Hall, Y....Carroll, M. W. (2023). Influence of Landscape Patterns on Exposure to Lassa Fever Virus, Guinea. Emerging Infectious Diseases, 29(2), 304-313. https://doi.org/10.3201/eid2902.212525.

Increased Multidrug-Resistant Salmonella enterica I Serotype 4,[5],12:i:- Infections Associated with Pork, United States, 2009–2018 [PDF - 859 KB - 9 pages]
I. D. Plumb et al.

Reports of Salmonella enterica I serotype 4,[5],12:i:- infections resistant to ampicillin, streptomycin, sulphamethoxazole, and tetracycline (ASSuT) have been increasing. We analyzed data from 5 national surveillance systems to describe the epidemiology, resistance traits, and genetics of infections with this Salmonella strain in the United States. We found ASSuT-resistant Salmonella 4,[5],12:i:- increased from 1.1% of Salmonella infections during 2009–2013 to 2.6% during 2014–2018; the proportion of Salmonella 4,[5],12:i:- isolates without this resistance pattern declined from 3.1% to 2.4% during the same timeframe. Among isolates sequenced during 2015–2018, a total of 69% were in the same phylogenetic clade. Within that clade, 77% of isolates had genetic determinants of ASSuT resistance, and 16% had genetic determinants of decreased susceptibility to ciprofloxacin, ceftriaxone, or azithromycin. Among outbreaks related to the multidrug-resistant clade, 63% were associated with pork consumption or contact with swine. Preventing Salmonella 4,[5],12:i:- carriage in swine would likely avert human infections with this strain.

EID Plumb ID, Brown AC, Stokes EK, Chen JC, Carleton H, Tolar B, et al. Increased Multidrug-Resistant Salmonella enterica I Serotype 4,[5],12:i:- Infections Associated with Pork, United States, 2009–2018. Emerg Infect Dis. 2023;29(2):314-322. https://doi.org/10.3201/eid2902.220950
AMA Plumb ID, Brown AC, Stokes EK, et al. Increased Multidrug-Resistant Salmonella enterica I Serotype 4,[5],12:i:- Infections Associated with Pork, United States, 2009–2018. Emerging Infectious Diseases. 2023;29(2):314-322. doi:10.3201/eid2902.220950.
APA Plumb, I. D., Brown, A. C., Stokes, E. K., Chen, J. C., Carleton, H., Tolar, B....Friedman, C. R. (2023). Increased Multidrug-Resistant Salmonella enterica I Serotype 4,[5],12:i:- Infections Associated with Pork, United States, 2009–2018. Emerging Infectious Diseases, 29(2), 314-322. https://doi.org/10.3201/eid2902.220950.

Novel Prion Strain as Cause of Chronic Wasting Disease in a Moose, Finland [PDF - 2.73 MB - 10 pages]
J. L. Sun et al.

Our previous studies using gene-targeted mouse models of chronic wasting disease (CWD) demonstrated that Norway and North America cervids are infected with distinct prion strains that respond differently to naturally occurring amino acid variation at residue 226 of the prion protein. Here we performed transmissions in gene-targeted mice to investigate the properties of prions causing newly emergent CWD in moose in Finland. Although CWD prions from Finland and Norway moose had comparable responses to primary structural differences at residue 226, other distinctive criteria, including transmission kinetics, patterns of neuronal degeneration, and conformational features of prions generated in the brains of diseased mice, demonstrated that the strain properties of Finland moose CWD prions are different from those previously characterized in Norway CWD. Our findings add to a growing body of evidence for a diverse portfolio of emergent strains in Nordic countries that are etiologically distinct from the comparatively consistent strain profile of North America CWD.

EID Sun JL, Kim S, Crowell J, Webster BK, Raisley EK, Lowe DC, et al. Novel Prion Strain as Cause of Chronic Wasting Disease in a Moose, Finland. Emerg Infect Dis. 2023;29(2):323-332. https://doi.org/10.3201/eid2902.220882
AMA Sun JL, Kim S, Crowell J, et al. Novel Prion Strain as Cause of Chronic Wasting Disease in a Moose, Finland. Emerging Infectious Diseases. 2023;29(2):323-332. doi:10.3201/eid2902.220882.
APA Sun, J. L., Kim, S., Crowell, J., Webster, B. K., Raisley, E. K., Lowe, D. C....Telling, G. C. (2023). Novel Prion Strain as Cause of Chronic Wasting Disease in a Moose, Finland. Emerging Infectious Diseases, 29(2), 323-332. https://doi.org/10.3201/eid2902.220882.

Novel Species of Brucella Causing Human Brucellosis, French Guiana [PDF - 2.35 MB - 8 pages]
F. About et al.

Human brucellosis is a zoonoses caused by bacteria of the genus Brucella. Infection results in subacute or chronic debilitating disease with nonspecific clinical manifestations and is often associated with consuming unpasteurized dairy products. We report 2 cases of brucellosis in male patients who were hospitalized in distinct towns of French Guiana, an overseas territory of France located on the northeastern shore of South America. Both men were citizens of Brazil working as clandestine goldminers in the deep Amazonian rainforest. Characterization of the 2 bacterial isolates revealed that they represent a potential new species of Brucella. Medical practitioners working in contact with wildlife in this region of the world should be aware of the existence of these pathogens and the potential for human infection.

EID About F, Pastre T, Boutrou M, Martinez A, Melzani A, Peugny S, et al. Novel Species of Brucella Causing Human Brucellosis, French Guiana. Emerg Infect Dis. 2023;29(2):333-340. https://doi.org/10.3201/eid2902.220725
AMA About F, Pastre T, Boutrou M, et al. Novel Species of Brucella Causing Human Brucellosis, French Guiana. Emerging Infectious Diseases. 2023;29(2):333-340. doi:10.3201/eid2902.220725.
APA About, F., Pastre, T., Boutrou, M., Martinez, A., Melzani, A., Peugny, S....Keriel, A. (2023). Novel Species of Brucella Causing Human Brucellosis, French Guiana. Emerging Infectious Diseases, 29(2), 333-340. https://doi.org/10.3201/eid2902.220725.

Penicillin and Cefotaxime Resistance of Quinolone-Resistant Neisseria meningitidis Clonal Complex 4821, Shanghai, China, 1965–2020 [PDF - 1.61 MB - 10 pages]
M. Chen et al.

Clonal complex 4821 (CC4821) Neisseria meningitidis, usually resistant to quinolones but susceptible to penicillin and third-generation cephalosporins, is increasing worldwide. To characterize the penicillin-nonsusceptible (PenNS) meningococci, we analyzed 491 meningococci and 724 commensal Neisseria isolates in Shanghai, China, during 1965–2020. The PenNS proportion increased from 0.3% in 1965–1985 to 7.0% in 2005–2014 and to 33.3% in 2015–2020. Of the 26 PenNS meningococci, 11 (42.3%) belonged to the CC4821 cluster; all possessed mutations in penicillin-binding protein 2, mostly from commensal Neisseria. Genetic analyses and transformation identified potential donors of 6 penA alleles. Three PenNS meningococci were resistant to cefotaxime, 2 within the CC4821 cluster. With 96% of the PenNS meningococci beyond the coverage of scheduled vaccination and the cefotaxime-resistant isolates all from toddlers, quinolone-resistant CC4821 has acquired penicillin and cefotaxime resistance closely related to the internationally disseminated ceftriaxone-resistant gonococcal FC428 clone, posing a greater threat especially to young children.

EID Chen M, Shao Y, Luo J, Yuan L, Wang M, Chen M, et al. Penicillin and Cefotaxime Resistance of Quinolone-Resistant Neisseria meningitidis Clonal Complex 4821, Shanghai, China, 1965–2020. Emerg Infect Dis. 2023;29(2):341-350. https://doi.org/10.3201/eid2902.221066
AMA Chen M, Shao Y, Luo J, et al. Penicillin and Cefotaxime Resistance of Quinolone-Resistant Neisseria meningitidis Clonal Complex 4821, Shanghai, China, 1965–2020. Emerging Infectious Diseases. 2023;29(2):341-350. doi:10.3201/eid2902.221066.
APA Chen, M., Shao, Y., Luo, J., Yuan, L., Wang, M., Chen, M....Guo, Q. (2023). Penicillin and Cefotaxime Resistance of Quinolone-Resistant Neisseria meningitidis Clonal Complex 4821, Shanghai, China, 1965–2020. Emerging Infectious Diseases, 29(2), 341-350. https://doi.org/10.3201/eid2902.221066.

Combined Phylogeographic Analyses and Epidemiologic Contact Tracing to Characterize Atypically Pathogenic Avian Influenza (H3N1) Epidemic, Belgium, 2019 [PDF - 1.81 MB - 9 pages]
S. Van Borm et al.

The high economic impact and zoonotic potential of avian influenza call for detailed investigations of dispersal dynamics of epidemics. We integrated phylogeographic and epidemiologic analyses to investigate the dynamics of a low pathogenicity avian influenza (H3N1) epidemic that occurred in Belgium during 2019. Virus genomes from 104 clinical samples originating from 85% of affected farms were sequenced. A spatially explicit phylogeographic analysis confirmed a dominating northeast to southwest dispersal direction and a long-distance dispersal event linked to direct live animal transportation between farms. Spatiotemporal clustering, transport, and social contacts strongly correlated with the phylogeographic pattern of the epidemic. We detected only a limited association between wind direction and direction of viral lineage dispersal. Our results highlight the multifactorial nature of avian influenza epidemics and illustrate the use of genomic analyses of virus dispersal to complement epidemiologic and environmental data, improve knowledge of avian influenza epidemiologic dynamics, and enhance control strategies.

EID Van Borm S, Boseret G, Dellicour S, Steensels M, Roupie V, Vandenbussche F, et al. Combined Phylogeographic Analyses and Epidemiologic Contact Tracing to Characterize Atypically Pathogenic Avian Influenza (H3N1) Epidemic, Belgium, 2019. Emerg Infect Dis. 2023;29(2):351-359. https://doi.org/10.3201/eid2902.220765
AMA Van Borm S, Boseret G, Dellicour S, et al. Combined Phylogeographic Analyses and Epidemiologic Contact Tracing to Characterize Atypically Pathogenic Avian Influenza (H3N1) Epidemic, Belgium, 2019. Emerging Infectious Diseases. 2023;29(2):351-359. doi:10.3201/eid2902.220765.
APA Van Borm, S., Boseret, G., Dellicour, S., Steensels, M., Roupie, V., Vandenbussche, F....van den Berg, T. (2023). Combined Phylogeographic Analyses and Epidemiologic Contact Tracing to Characterize Atypically Pathogenic Avian Influenza (H3N1) Epidemic, Belgium, 2019. Emerging Infectious Diseases, 29(2), 351-359. https://doi.org/10.3201/eid2902.220765.

Age-Stratified Model to Assess Health Outcomes of COVID-19 Vaccination Strategies, Ghana [PDF - 1.34 MB - 11 pages]
S. K. Ofori et al.

We assessed the effect of various COVID-19 vaccination strategies on health outcomes in Ghana by using an age-stratified compartmental model. We stratified the population into 3 age groups: <25 years, 25–64 years, and ≥65 years. We explored 5 vaccination optimization scenarios using 2 contact matrices, assuming that 1 million persons could be vaccinated in either 3 or 6 months. We assessed these vaccine optimization strategies for the initial strain, followed by a sensitivity analysis for the Delta variant. We found that vaccinating persons <25 years of age was associated with the lowest cumulative infections for the main matrix, for both the initial strain and the Delta variant. Prioritizing the elderly (≥65 years of age) was associated with the lowest cumulative deaths for both strains in all scenarios. The consensus between the findings of both contact matrices depended on the vaccine rollout period and the objective of the vaccination program.

EID Ofori SK, Schwind JS, Sullivan KL, Chowell G, Cowling BJ, Fung I. Age-Stratified Model to Assess Health Outcomes of COVID-19 Vaccination Strategies, Ghana. Emerg Infect Dis. 2023;29(2):360-370. https://doi.org/10.3201/eid2902.221098
AMA Ofori SK, Schwind JS, Sullivan KL, et al. Age-Stratified Model to Assess Health Outcomes of COVID-19 Vaccination Strategies, Ghana. Emerging Infectious Diseases. 2023;29(2):360-370. doi:10.3201/eid2902.221098.
APA Ofori, S. K., Schwind, J. S., Sullivan, K. L., Chowell, G., Cowling, B. J., & Fung, I. (2023). Age-Stratified Model to Assess Health Outcomes of COVID-19 Vaccination Strategies, Ghana. Emerging Infectious Diseases, 29(2), 360-370. https://doi.org/10.3201/eid2902.221098.

Early Introduction and Community Transmission of SARS-CoV-2 Omicron Variant, New York, New York, USA [PDF - 3.14 MB - 10 pages]
D. Liu et al.

The Omicron variant of SARS-CoV-2 has become dominant in most countries and has raised significant global health concerns. As a global commerce center, New York, New York, USA, constantly faces the risk for multiple variant introductions of SARS-CoV-2. To elucidate the introduction and transmission of the Omicron variant in the city of New York, we created a comprehensive genomic and epidemiologic analysis of 392 Omicron virus specimens collected during November 25–December 11, 2021. We found evidence of 4 independent introductions of Omicron subclades, including the Omicron subclade BA.1.1 with defining substitution of R346K in the spike protein. The continuous genetic divergence within each Omicron subclade revealed their local community transmission and co-circulation in New York, including both household and workplace transmissions supported by epidemiologic evidence. Our study highlights the urgent need for enhanced genomic surveillance and effective response planning for better prevention and management of emerging SARS-CoV-2 variants.

EID Liu D, Cheng Y, Zhou H, Wang L, Fiel R, Gruenstein Y, et al. Early Introduction and Community Transmission of SARS-CoV-2 Omicron Variant, New York, New York, USA. Emerg Infect Dis. 2023;29(2):371-380. https://doi.org/10.3201/eid2902.220817
AMA Liu D, Cheng Y, Zhou H, et al. Early Introduction and Community Transmission of SARS-CoV-2 Omicron Variant, New York, New York, USA. Emerging Infectious Diseases. 2023;29(2):371-380. doi:10.3201/eid2902.220817.
APA Liu, D., Cheng, Y., Zhou, H., Wang, L., Fiel, R., Gruenstein, Y....Rodgers, W. (2023). Early Introduction and Community Transmission of SARS-CoV-2 Omicron Variant, New York, New York, USA. Emerging Infectious Diseases, 29(2), 371-380. https://doi.org/10.3201/eid2902.220817.

Correlates of Protection, Thresholds of Protection, and Immunobridging among Persons with SARS-CoV-2 Infection [PDF - 1.86 MB - 8 pages]
D. S. Khoury et al.

Several studies have shown that neutralizing antibody levels correlate with immune protection from COVID-19 and have estimated the relationship between neutralizing antibodies and protection. However, results of these studies vary in terms of estimates of the level of neutralizing antibodies required for protection. By normalizing antibody titers, we found that study results converge on a consistent relationship between antibody levels and protection from COVID-19. This finding can be useful for planning future vaccine use, determining population immunity, and reducing the global effects of the COVID-19 pandemic

EID Khoury DS, Schlub TE, Cromer D, Steain M, Fong Y, Gilbert PB, et al. Correlates of Protection, Thresholds of Protection, and Immunobridging among Persons with SARS-CoV-2 Infection. Emerg Infect Dis. 2023;29(2):381-388. https://doi.org/10.3201/eid2902.221422
AMA Khoury DS, Schlub TE, Cromer D, et al. Correlates of Protection, Thresholds of Protection, and Immunobridging among Persons with SARS-CoV-2 Infection. Emerging Infectious Diseases. 2023;29(2):381-388. doi:10.3201/eid2902.221422.
APA Khoury, D. S., Schlub, T. E., Cromer, D., Steain, M., Fong, Y., Gilbert, P. B....Davenport, M. P. (2023). Correlates of Protection, Thresholds of Protection, and Immunobridging among Persons with SARS-CoV-2 Infection. Emerging Infectious Diseases, 29(2), 381-388. https://doi.org/10.3201/eid2902.221422.
Dispatches

Longitudinal Analysis of Electronic Health Information to Identify Possible COVID-19 Sequelae [PDF - 266 KB - 4 pages]
E. S. Click et al.

Ongoing symptoms might follow acute COVID-19. Using electronic health information, we compared pre‒ and post‒COVID-19 diagnostic codes to identify symptoms that had higher encounter incidence in the post‒COVID-19 period as sequelae. This method can be used for hypothesis generation and ongoing monitoring of sequelae of COVID-19 and future emerging diseases.

EID Click ES, Malec D, Chevinsky JR, Tao G, Melgar M, Giovanni JE, et al. Longitudinal Analysis of Electronic Health Information to Identify Possible COVID-19 Sequelae. Emerg Infect Dis. 2023;29(2):389-392. https://doi.org/10.3201/eid2902.220712
AMA Click ES, Malec D, Chevinsky JR, et al. Longitudinal Analysis of Electronic Health Information to Identify Possible COVID-19 Sequelae. Emerging Infectious Diseases. 2023;29(2):389-392. doi:10.3201/eid2902.220712.
APA Click, E. S., Malec, D., Chevinsky, J. R., Tao, G., Melgar, M., Giovanni, J. E....Wong, K. K. (2023). Longitudinal Analysis of Electronic Health Information to Identify Possible COVID-19 Sequelae. Emerging Infectious Diseases, 29(2), 389-392. https://doi.org/10.3201/eid2902.220712.

Nipah Virus Exposure in Domestic and Peridomestic Animals Living in Human Outbreak Sites, Bangladesh, 2013–2015 [PDF - 722 KB - 4 pages]
A. Islam et al.

Spillovers of Nipah virus (NiV) from Pteropus bats to humans occurs frequently in Bangladesh, but the risk for spillover into other animals is poorly understood. We detected NiV antibodies in cattle, dogs, and cats from 6 sites where spillover human NiV infection cases occurred during 2013–2015.

EID Islam A, Cannon DL, Rahman M, Khan S, Epstein JH, Daszak P, et al. Nipah Virus Exposure in Domestic and Peridomestic Animals Living in Human Outbreak Sites, Bangladesh, 2013–2015. Emerg Infect Dis. 2023;29(2):393-396. https://doi.org/10.3201/eid2902.221379
AMA Islam A, Cannon DL, Rahman M, et al. Nipah Virus Exposure in Domestic and Peridomestic Animals Living in Human Outbreak Sites, Bangladesh, 2013–2015. Emerging Infectious Diseases. 2023;29(2):393-396. doi:10.3201/eid2902.221379.
APA Islam, A., Cannon, D. L., Rahman, M., Khan, S., Epstein, J. H., Daszak, P....Gurley, E. S. (2023). Nipah Virus Exposure in Domestic and Peridomestic Animals Living in Human Outbreak Sites, Bangladesh, 2013–2015. Emerging Infectious Diseases, 29(2), 393-396. https://doi.org/10.3201/eid2902.221379.

(Mis)perception and Use of Unsterile Water in Home Medical Devices, PN View 360+ Survey, United States, August 2021 [PDF - 555 KB - 5 pages]
S. Miko et al.

Tap water is not sterile, and its use in home medical devices can result in infections from waterborne pathogens. However, many participants in a recent survey in the United States said tap water could safely be used for home medical devices. These results can inform communication materials to reduce the high consequence of infections.

EID Miko S, Collier SA, Burns-Lynch CE, Andújar AA, Benedict KM, Haston JC, et al. (Mis)perception and Use of Unsterile Water in Home Medical Devices, PN View 360+ Survey, United States, August 2021. Emerg Infect Dis. 2023;29(2):397-401. https://doi.org/10.3201/eid2902.221205
AMA Miko S, Collier SA, Burns-Lynch CE, et al. (Mis)perception and Use of Unsterile Water in Home Medical Devices, PN View 360+ Survey, United States, August 2021. Emerging Infectious Diseases. 2023;29(2):397-401. doi:10.3201/eid2902.221205.
APA Miko, S., Collier, S. A., Burns-Lynch, C. E., Andújar, A. A., Benedict, K. M., Haston, J. C....Cope, J. R. (2023). (Mis)perception and Use of Unsterile Water in Home Medical Devices, PN View 360+ Survey, United States, August 2021. Emerging Infectious Diseases, 29(2), 397-401. https://doi.org/10.3201/eid2902.221205.

Molecular Detection of Candidatus Orientia chuto in Wildlife, Saudi Arabia [PDF - 1.20 MB - 5 pages]
H. A. Alkathiry et al.

Scrub typhus is a zoonosis caused by 3 species of Orientia bacteria, including Candidatus Orientia chuto. This species is known only from a human case in Dubai and infections in wildlife in Kenya. We report molecular detection of Candidatus O. chuto in 2 wild rodent species from Saudi Arabia.

EID Alkathiry HA, Alghamdi SQ, Morgan H, Noll ME, Khoo JJ, Alagaili AN, et al. Molecular Detection of Candidatus Orientia chuto in Wildlife, Saudi Arabia. Emerg Infect Dis. 2023;29(2):402-406. https://doi.org/10.3201/eid2902.221131
AMA Alkathiry HA, Alghamdi SQ, Morgan H, et al. Molecular Detection of Candidatus Orientia chuto in Wildlife, Saudi Arabia. Emerging Infectious Diseases. 2023;29(2):402-406. doi:10.3201/eid2902.221131.
APA Alkathiry, H. A., Alghamdi, S. Q., Morgan, H., Noll, M. E., Khoo, J. J., Alagaili, A. N....Makepeace, B. L. (2023). Molecular Detection of Candidatus Orientia chuto in Wildlife, Saudi Arabia. Emerging Infectious Diseases, 29(2), 402-406. https://doi.org/10.3201/eid2902.221131.

Neoehrlichiosis in Symptomatic Immunocompetent Child, South Africa [PDF - 886 KB - 4 pages]
C. Bamford et al.

We describe a case of neoehrlichiosis in an immunocompetent child with acute febrile illness in South Africa. Neoehrlichiosis was diagnosed by PCR on 16S rDNA from bone marrow aspirate. Phylogenetic analysis indicated an organism closely related to Candidatus Neoehrlichia. Clinicians should be aware of possible ehrlichiosis even in immunocompetent patients.

EID Bamford C, Blumberg LH, Bosman M, Frean J, Hoek K, Miles J, et al. Neoehrlichiosis in Symptomatic Immunocompetent Child, South Africa. Emerg Infect Dis. 2023;29(2):407-410. https://doi.org/10.3201/eid2902.221451
AMA Bamford C, Blumberg LH, Bosman M, et al. Neoehrlichiosis in Symptomatic Immunocompetent Child, South Africa. Emerging Infectious Diseases. 2023;29(2):407-410. doi:10.3201/eid2902.221451.
APA Bamford, C., Blumberg, L. H., Bosman, M., Frean, J., Hoek, K., Miles, J....Oosthuizen, M. C. (2023). Neoehrlichiosis in Symptomatic Immunocompetent Child, South Africa. Emerging Infectious Diseases, 29(2), 407-410. https://doi.org/10.3201/eid2902.221451.

Successful Drug-Mediated Host Clearance of Batrachochytrium salamandrivorans [PDF - 1.53 MB - 4 pages]
A. Plewnia et al.

Skin fungi are among the most dangerous drivers of global amphibian declines, and few mitigation strategies are known. For Batrachochytrium salamandrivorans (Chytridiomycota), available treatments rely on temperature, partially combined with antifungal drugs. We report the clearance of B. salamandrivorans in 2 urodelan species using a solely drug-based approach.

EID Plewnia A, Lötters S, Veith M, Peters M, Böning P. Successful Drug-Mediated Host Clearance of Batrachochytrium salamandrivorans. Emerg Infect Dis. 2023;29(2):411-414. https://doi.org/10.3201/eid2902.221162
AMA Plewnia A, Lötters S, Veith M, et al. Successful Drug-Mediated Host Clearance of Batrachochytrium salamandrivorans. Emerging Infectious Diseases. 2023;29(2):411-414. doi:10.3201/eid2902.221162.
APA Plewnia, A., Lötters, S., Veith, M., Peters, M., & Böning, P. (2023). Successful Drug-Mediated Host Clearance of Batrachochytrium salamandrivorans. Emerging Infectious Diseases, 29(2), 411-414. https://doi.org/10.3201/eid2902.221162.

Powassan Virus Lineage I in Field-Collected Dermacentor variabilis Ticks, New York, USA [PDF - 1.13 MB - 3 pages]
C. Hart et al.

Powassan virus is a tickborne flavivirus that can cause lethal or debilitating neurologic illness. It is canonically transmitted by Ixodes spp. ticks but might spill over to sympatric Dermacentor species. We detected Powassan virus lineage I from a pool of field-collected D. variabilis ticks in New York, USA.

EID Hart C, Hassett E, Vogels C, Shapley D, Grubaugh ND, Thangamani S. Powassan Virus Lineage I in Field-Collected Dermacentor variabilis Ticks, New York, USA. Emerg Infect Dis. 2023;29(2):415-417. https://doi.org/10.3201/eid2902.220410
AMA Hart C, Hassett E, Vogels C, et al. Powassan Virus Lineage I in Field-Collected Dermacentor variabilis Ticks, New York, USA. Emerging Infectious Diseases. 2023;29(2):415-417. doi:10.3201/eid2902.220410.
APA Hart, C., Hassett, E., Vogels, C., Shapley, D., Grubaugh, N. D., & Thangamani, S. (2023). Powassan Virus Lineage I in Field-Collected Dermacentor variabilis Ticks, New York, USA. Emerging Infectious Diseases, 29(2), 415-417. https://doi.org/10.3201/eid2902.220410.

Bartonella spp. and Typhus Group Rickettsiae among Persons Experiencing Homelessness, São Paulo, Brazil [PDF - 315 KB - 4 pages]
Á. A. Faccini-Martínez et al.

Persons experiencing homelessness in São Paulo, Brazil, were seropositive for Bartonella spp. (79/109, 72.5%) and typhus group rickettsiae (40/109, 36.7%). Bartonella quintana DNA was detected in 17.1% (14/82) body louse pools and 0.9% (1/114) blood samples. Clinicians should consider vectorborne agents as potential causes of febrile syndromes in this population.

EID Faccini-Martínez ÁA, Kmetiuk L, Blanton LS, Felipetto L, Gravinatti M, Timenetsky J, et al. Bartonella spp. and Typhus Group Rickettsiae among Persons Experiencing Homelessness, São Paulo, Brazil. Emerg Infect Dis. 2023;29(2):418-421. https://doi.org/10.3201/eid2902.221050
AMA Faccini-Martínez ÁA, Kmetiuk L, Blanton LS, et al. Bartonella spp. and Typhus Group Rickettsiae among Persons Experiencing Homelessness, São Paulo, Brazil. Emerging Infectious Diseases. 2023;29(2):418-421. doi:10.3201/eid2902.221050.
APA Faccini-Martínez, Á. A., Kmetiuk, L., Blanton, L. S., Felipetto, L., Gravinatti, M., Timenetsky, J....Walker, D. H. (2023). Bartonella spp. and Typhus Group Rickettsiae among Persons Experiencing Homelessness, São Paulo, Brazil. Emerging Infectious Diseases, 29(2), 418-421. https://doi.org/10.3201/eid2902.221050.

Candida auris Discovery through Community Wastewater Surveillance during Healthcare Outbreak, Nevada, USA, 2022 [PDF - 1.14 MB - 4 pages]
A. Rossi et al.

Candida auris transmission is steadily increasing across the United States. We report culture-based detection of C. auris in wastewater and the epidemiologic link between isolated strains and southern Nevada, USA, hospitals within the sampled sewershed. Our results illustrate the potential of wastewater surveillance for containing C. auris.

EID Rossi A, Chavez J, Iverson T, Hergert J, Oakeson K, LaCross N, et al. Candida auris Discovery through Community Wastewater Surveillance during Healthcare Outbreak, Nevada, USA, 2022. Emerg Infect Dis. 2023;29(2):422-425. https://doi.org/10.3201/eid2902.221523
AMA Rossi A, Chavez J, Iverson T, et al. Candida auris Discovery through Community Wastewater Surveillance during Healthcare Outbreak, Nevada, USA, 2022. Emerging Infectious Diseases. 2023;29(2):422-425. doi:10.3201/eid2902.221523.
APA Rossi, A., Chavez, J., Iverson, T., Hergert, J., Oakeson, K., LaCross, N....Gerrity, D. (2023). Candida auris Discovery through Community Wastewater Surveillance during Healthcare Outbreak, Nevada, USA, 2022. Emerging Infectious Diseases, 29(2), 422-425. https://doi.org/10.3201/eid2902.221523.

Estimated Cases Averted by COVID-19 Digital Exposure Notification, Pennsylvania, USA, November 8, 2020–January 2, 2021 [PDF - 913 KB - 5 pages]
S. Jeon et al.

We combined field-based data with mathematical modeling to estimate the effectiveness of smartphone-enabled COVID-19 exposure notification in Pennsylvania, USA. We estimated that digital notifications potentially averted 7–69 cases/1,000 notifications during November 8, 2020–January 2, 2021. Greater use and increased compliance could increase the effectiveness of digital notifications.

EID Jeon S, Rainisch G, Harris A, Shinabery J, Iqbal M, Pallavaram A, et al. Estimated Cases Averted by COVID-19 Digital Exposure Notification, Pennsylvania, USA, November 8, 2020–January 2, 2021. Emerg Infect Dis. 2023;29(2):426-430. https://doi.org/10.3201/eid2902.220959
AMA Jeon S, Rainisch G, Harris A, et al. Estimated Cases Averted by COVID-19 Digital Exposure Notification, Pennsylvania, USA, November 8, 2020–January 2, 2021. Emerging Infectious Diseases. 2023;29(2):426-430. doi:10.3201/eid2902.220959.
APA Jeon, S., Rainisch, G., Harris, A., Shinabery, J., Iqbal, M., Pallavaram, A....Meltzer, M. I. (2023). Estimated Cases Averted by COVID-19 Digital Exposure Notification, Pennsylvania, USA, November 8, 2020–January 2, 2021. Emerging Infectious Diseases, 29(2), 426-430. https://doi.org/10.3201/eid2902.220959.
Commentaries

Next-Generation Sequencing for Identifying Unknown Pathogens in Sentinel Immunocompromised Hosts [PDF - 191 KB - 2 pages]
J. A. Fishman
EID Fishman JA. Next-Generation Sequencing for Identifying Unknown Pathogens in Sentinel Immunocompromised Hosts. Emerg Infect Dis. 2023;29(2):431-432. https://doi.org/10.3201/eid2902.221829
AMA Fishman JA. Next-Generation Sequencing for Identifying Unknown Pathogens in Sentinel Immunocompromised Hosts. Emerging Infectious Diseases. 2023;29(2):431-432. doi:10.3201/eid2902.221829.
APA Fishman, J. A. (2023). Next-Generation Sequencing for Identifying Unknown Pathogens in Sentinel Immunocompromised Hosts. Emerging Infectious Diseases, 29(2), 431-432. https://doi.org/10.3201/eid2902.221829.
Research Letters

Orthopoxvirus Infections in Rodents, Nigeria, 2018–2019 [PDF - 643 KB - 2 pages]
C. Meseko et al.

To investigate animal reservoirs of monkeypox virus in Nigeria, we sampled 240 rodents during 2018–2019. Molecular (real-time PCR) and serologic (IgM) evidence indicated orthopoxvirus infections, but presence of monkeypox virus was not confirmed. These results can be used to develop public health interventions to reduce human infection with orthopoxviruses.

EID Meseko C, Adedeji A, Shittu I, Obishakin E, Nanven M, Suleiman L, et al. Orthopoxvirus Infections in Rodents, Nigeria, 2018–2019. Emerg Infect Dis. 2023;29(2):433-434. https://doi.org/10.3201/eid2902.221411
AMA Meseko C, Adedeji A, Shittu I, et al. Orthopoxvirus Infections in Rodents, Nigeria, 2018–2019. Emerging Infectious Diseases. 2023;29(2):433-434. doi:10.3201/eid2902.221411.
APA Meseko, C., Adedeji, A., Shittu, I., Obishakin, E., Nanven, M., Suleiman, L....Doty, J. B. (2023). Orthopoxvirus Infections in Rodents, Nigeria, 2018–2019. Emerging Infectious Diseases, 29(2), 433-434. https://doi.org/10.3201/eid2902.221411.

Occupational Monkeypox Virus Transmission to Healthcare Worker, California, USA, 2022 [PDF - 843 KB - 3 pages]
J. Alarcón et al.

Risk for transmission of monkeypox virus (MPXV) (clade IIb) to healthcare workers (HCWs) is low. Although many cases have been reported among HCW, only a few have been occupationally acquired. We report a case of non–needle stick MPXV transmission to an HCW in the United States.

EID Alarcón J, Kim M, Balanji N, Davis A, Mata F, Karan A, et al. Occupational Monkeypox Virus Transmission to Healthcare Worker, California, USA, 2022. Emerg Infect Dis. 2023;29(2):435-437. https://doi.org/10.3201/eid2902.221750
AMA Alarcón J, Kim M, Balanji N, et al. Occupational Monkeypox Virus Transmission to Healthcare Worker, California, USA, 2022. Emerging Infectious Diseases. 2023;29(2):435-437. doi:10.3201/eid2902.221750.
APA Alarcón, J., Kim, M., Balanji, N., Davis, A., Mata, F., Karan, A....Balter, S. E. (2023). Occupational Monkeypox Virus Transmission to Healthcare Worker, California, USA, 2022. Emerging Infectious Diseases, 29(2), 435-437. https://doi.org/10.3201/eid2902.221750.

Familial Monkeypox Virus Infection Involving 2 Young Children [PDF - 648 KB - 3 pages]
P. Del Giudice et al.

We report intrafamilial transmission of monkeypox virus to all members of a family (father, mother, and 2 children). Case reports in young children have been extremely rare during the 2022 mpox outbreak. Their clinical signs were mild, and clinical diagnosis would be difficult without knowledge of the father’s monkeypox virus infection.

EID Del Giudice P, Fribourg A, Roudiere L, Gillon J, Decoppet A, Reverte M. Familial Monkeypox Virus Infection Involving 2 Young Children. Emerg Infect Dis. 2023;29(2):437-439. https://doi.org/10.3201/eid2902.221674
AMA Del Giudice P, Fribourg A, Roudiere L, et al. Familial Monkeypox Virus Infection Involving 2 Young Children. Emerging Infectious Diseases. 2023;29(2):437-439. doi:10.3201/eid2902.221674.
APA Del Giudice, P., Fribourg, A., Roudiere, L., Gillon, J., Decoppet, A., & Reverte, M. (2023). Familial Monkeypox Virus Infection Involving 2 Young Children. Emerging Infectious Diseases, 29(2), 437-439. https://doi.org/10.3201/eid2902.221674.

Dirofilaria immitis in Dog Imported from Venezuela to Chile [PDF - 347 KB - 3 pages]
C. A. Alvarez Rojas et al.

We report a case of Dirofilaria immitis nematode infection in a dog imported from Venezuela that had been living for 2 years in Santiago, Chile, where this parasite had not been reported before. Our findings warrant surveillance for all dogs imported to Chile, given that suitable conditions exist for establishing this parasite.

EID Alvarez Rojas CA, Cancino-Faure B, Lillo P, Fernández M, González A, Ramírez A. Dirofilaria immitis in Dog Imported from Venezuela to Chile. Emerg Infect Dis. 2023;29(2):439-441. https://doi.org/10.3201/eid2902.221427
AMA Alvarez Rojas CA, Cancino-Faure B, Lillo P, et al. Dirofilaria immitis in Dog Imported from Venezuela to Chile. Emerging Infectious Diseases. 2023;29(2):439-441. doi:10.3201/eid2902.221427.
APA Alvarez Rojas, C. A., Cancino-Faure, B., Lillo, P., Fernández, M., González, A., & Ramírez, A. (2023). Dirofilaria immitis in Dog Imported from Venezuela to Chile. Emerging Infectious Diseases, 29(2), 439-441. https://doi.org/10.3201/eid2902.221427.

Relapsing Fever Caused by Borrelia lonestari after Tick Bite in Alabama, USA [PDF - 749 KB - 4 pages]
L. J. Vazquez Guillamet et al.

We report an immunocompromised patient in Alabama, USA, 75 years of age, with relapsing fevers and pancytopenia who had spirochetemia after a tick bite. We identified Borrelia lonestari by using PCR, sequencing, and phylogenetic analysis. Increasing clinical availability of molecular diagnostics might identify B. lonestari as an emerging tickborne pathogen.

EID Vazquez Guillamet LJ, Marx GE, Benjamin W, Pappas P, Lieberman N, Bachiashvili K, et al. Relapsing Fever Caused by Borrelia lonestari after Tick Bite in Alabama, USA. Emerg Infect Dis. 2023;29(2):441-444. https://doi.org/10.3201/eid2902.221281
AMA Vazquez Guillamet LJ, Marx GE, Benjamin W, et al. Relapsing Fever Caused by Borrelia lonestari after Tick Bite in Alabama, USA. Emerging Infectious Diseases. 2023;29(2):441-444. doi:10.3201/eid2902.221281.
APA Vazquez Guillamet, L. J., Marx, G. E., Benjamin, W., Pappas, P., Lieberman, N., Bachiashvili, K....Lieberman, J. A. (2023). Relapsing Fever Caused by Borrelia lonestari after Tick Bite in Alabama, USA. Emerging Infectious Diseases, 29(2), 441-444. https://doi.org/10.3201/eid2902.221281.

Nocardia neocaledoniensis as Rare Cause of Spondylodiscitis [PDF - 499 KB - 2 pages]
E. Choquet et al.

Nocardia neocaledoniensis is a rare species of Nocardia bacteria, identified in 2004 in hypermagnesian ultramafic soil of New Caledonia. Culture of this opportunistic pathogen from spinal biopsy samples confirmed N. neocaledoniensis spondylodiscitis in an immunocompromised man. Isolation of this unusual species from spinal biopsy samples illustrates its underappreciated ability to cause invasive infection.

EID Choquet E, Rodriguez-Nava V, Peltier F, Wankap-Mogo R, Bergeron E, Joseph C, et al. Nocardia neocaledoniensis as Rare Cause of Spondylodiscitis. Emerg Infect Dis. 2023;29(2):444-446. https://doi.org/10.3201/eid2902.221389
AMA Choquet E, Rodriguez-Nava V, Peltier F, et al. Nocardia neocaledoniensis as Rare Cause of Spondylodiscitis. Emerging Infectious Diseases. 2023;29(2):444-446. doi:10.3201/eid2902.221389.
APA Choquet, E., Rodriguez-Nava, V., Peltier, F., Wankap-Mogo, R., Bergeron, E., Joseph, C....Lemaitre, N. (2023). Nocardia neocaledoniensis as Rare Cause of Spondylodiscitis. Emerging Infectious Diseases, 29(2), 444-446. https://doi.org/10.3201/eid2902.221389.

Cryptococcus tetragattii Meningitis Associated with Travel, Taiwan [PDF - 272 KB - 2 pages]
P. Wu et al.

Meningitis caused by Cryptococcus tetragattii fungus is rare and has been found in specific geographic regions. We report a case of meningitis caused by C. tetragattii (molecular type VGIV) in an immunocompetent patient in Taiwan. The patient had traveled to Egypt and was positive for granulocyte-macrophage colony-stimulating factor autoantibody.

EID Wu P, Chen C, Lin Y, Ao Y, Lin K, Hsih W, et al. Cryptococcus tetragattii Meningitis Associated with Travel, Taiwan. Emerg Infect Dis. 2023;29(2):447-448. https://doi.org/10.3201/eid2902.221425
AMA Wu P, Chen C, Lin Y, et al. Cryptococcus tetragattii Meningitis Associated with Travel, Taiwan. Emerging Infectious Diseases. 2023;29(2):447-448. doi:10.3201/eid2902.221425.
APA Wu, P., Chen, C., Lin, Y., Ao, Y., Lin, K., Hsih, W....Hsueh, P. (2023). Cryptococcus tetragattii Meningitis Associated with Travel, Taiwan. Emerging Infectious Diseases, 29(2), 447-448. https://doi.org/10.3201/eid2902.221425.

Metagenomic Sequencing of Monkeypox Virus, Northern Mexico [PDF - 484 KB - 3 pages]
K. A. Galán-Huerta et al.

Monkeypox virus (MPXV) has gained interest because of a multicountry outbreak of mpox (formerly monkeypox) cases with no epidemiologic link to MPXV-endemic regions. We sequenced the complete genome of MPXV isolated from a patient in northern Mexico. Phylogenetic analysis grouped the virus with isolates from Germany.

EID Galán-Huerta KA, Paz-Infanzon M, Nuzzolo-Shihadeh L, Ruiz-Higareda AF, Bocanegra-Ibarias P, Villareal-Martínez DZ, et al. Metagenomic Sequencing of Monkeypox Virus, Northern Mexico. Emerg Infect Dis. 2023;29(2):448-450. https://doi.org/10.3201/eid2902.221199
AMA Galán-Huerta KA, Paz-Infanzon M, Nuzzolo-Shihadeh L, et al. Metagenomic Sequencing of Monkeypox Virus, Northern Mexico. Emerging Infectious Diseases. 2023;29(2):448-450. doi:10.3201/eid2902.221199.
APA Galán-Huerta, K. A., Paz-Infanzon, M., Nuzzolo-Shihadeh, L., Ruiz-Higareda, A. F., Bocanegra-Ibarias, P., Villareal-Martínez, D. Z....Camacho-Ortiz, A. (2023). Metagenomic Sequencing of Monkeypox Virus, Northern Mexico. Emerging Infectious Diseases, 29(2), 448-450. https://doi.org/10.3201/eid2902.221199.

Monkeypox Virus Evolution before 2022 Outbreak [PDF - 1.71 MB - 3 pages]
E. Dumonteil et al.

Phylogenetic analysis of monkeypox virus genomes showed statistically significant divergence and nascent subclades during the 2022 mpox outbreak. Frequency of G>A/C>T transitions has increased in recent years, probably resulting from apolipoprotein B mRNA editing enzyme catalytic polypeptide 3G (APOBEC3) deaminase editing. This microevolutionary pattern most likely reflects community spread of the virus and adaptation to humans.

EID Dumonteil E, Herrera C, Sabino-Santos G. Monkeypox Virus Evolution before 2022 Outbreak. Emerg Infect Dis. 2023;29(2):451-453. https://doi.org/10.3201/eid2902.220962
AMA Dumonteil E, Herrera C, Sabino-Santos G. Monkeypox Virus Evolution before 2022 Outbreak. Emerging Infectious Diseases. 2023;29(2):451-453. doi:10.3201/eid2902.220962.
APA Dumonteil, E., Herrera, C., & Sabino-Santos, G. (2023). Monkeypox Virus Evolution before 2022 Outbreak. Emerging Infectious Diseases, 29(2), 451-453. https://doi.org/10.3201/eid2902.220962.

Epidemiology of SARS-CoV-2 Omicron BA.5 Infections, Macau, June–July 2022 [PDF - 957 KB - 4 pages]
W. Xiong et al.

A SARS-CoV-2 Omicron BA.5 outbreak occurred in Macau from mid-June through July 2022. Out of >1,800 laboratory-confirmed cases, most were mild or asymptomatic; only 6 deaths were recorded. The outbreak was controlled through stringent public health and social measures, such as repeated universal testing and a stay-at-home order lasting 2 weeks.

EID Xiong W, Peng L, Tsang TK, Cowling BJ. Epidemiology of SARS-CoV-2 Omicron BA.5 Infections, Macau, June–July 2022. Emerg Infect Dis. 2023;29(2):453-456. https://doi.org/10.3201/eid2902.221243
AMA Xiong W, Peng L, Tsang TK, et al. Epidemiology of SARS-CoV-2 Omicron BA.5 Infections, Macau, June–July 2022. Emerging Infectious Diseases. 2023;29(2):453-456. doi:10.3201/eid2902.221243.
APA Xiong, W., Peng, L., Tsang, T. K., & Cowling, B. J. (2023). Epidemiology of SARS-CoV-2 Omicron BA.5 Infections, Macau, June–July 2022. Emerging Infectious Diseases, 29(2), 453-456. https://doi.org/10.3201/eid2902.221243.

Serologic Evidence of Orientia Infection among Rural Population, Cauca Department, Colombia [PDF - 947 KB - 4 pages]
Á. A. Faccini-Martínez et al.

We assessed serum samples collected in Cauca Department, Colombia, from 486 persons for Orientia seroreactivity. Overall, 13.8% showed reactive IgG by indirect immunofluorescence antibody assay and ELISA. Of those samples, 30% (20/67) were confirmed to be positive by Western blot, showing >1 reactive band to Orientia 56-kD or 47-kD antigens.

EID Faccini-Martínez ÁA, Silva-Ramos C, Blanton LS, Arroyave E, Martínez-Diaz H, Betancourt-Ruiz P, et al. Serologic Evidence of Orientia Infection among Rural Population, Cauca Department, Colombia. Emerg Infect Dis. 2023;29(2):456-459. https://doi.org/10.3201/eid2902.221458
AMA Faccini-Martínez ÁA, Silva-Ramos C, Blanton LS, et al. Serologic Evidence of Orientia Infection among Rural Population, Cauca Department, Colombia. Emerging Infectious Diseases. 2023;29(2):456-459. doi:10.3201/eid2902.221458.
APA Faccini-Martínez, Á. A., Silva-Ramos, C., Blanton, L. S., Arroyave, E., Martínez-Diaz, H., Betancourt-Ruiz, P....Walker, D. H. (2023). Serologic Evidence of Orientia Infection among Rural Population, Cauca Department, Colombia. Emerging Infectious Diseases, 29(2), 456-459. https://doi.org/10.3201/eid2902.221458.
Letters

Hepatitis E Virus Outbreak among Tigray War Refugees from Ethopia, Sudan [PDF - 235 KB - 1 page]
A. S. Azman et al.
EID Azman AS, Gignoux E, Nesbitt R, Rumunu J, Aggarwal R, Ciglenecki I. Hepatitis E Virus Outbreak among Tigray War Refugees from Ethopia, Sudan. Emerg Infect Dis. 2023;29(2):460. https://doi.org/10.3201/eid2902.221495
AMA Azman AS, Gignoux E, Nesbitt R, et al. Hepatitis E Virus Outbreak among Tigray War Refugees from Ethopia, Sudan. Emerging Infectious Diseases. 2023;29(2):460. doi:10.3201/eid2902.221495.
APA Azman, A. S., Gignoux, E., Nesbitt, R., Rumunu, J., Aggarwal, R., & Ciglenecki, I. (2023). Hepatitis E Virus Outbreak among Tigray War Refugees from Ethopia, Sudan. Emerging Infectious Diseases, 29(2), 460. https://doi.org/10.3201/eid2902.221495.

Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan (Response) [PDF - 532 KB - 2 pages]
A. Ahmed et al.
EID Ahmed A, Ali Y, Mohamed NS, Zinsstag J, Siddig E, Khairy A. Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan (Response). Emerg Infect Dis. 2023;29(2):461. https://doi.org/10.3201/eid2902.221796
AMA Ahmed A, Ali Y, Mohamed NS, et al. Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan (Response). Emerging Infectious Diseases. 2023;29(2):461. doi:10.3201/eid2902.221796.
APA Ahmed, A., Ali, Y., Mohamed, N. S., Zinsstag, J., Siddig, E., & Khairy, A. (2023). Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan (Response). Emerging Infectious Diseases, 29(2), 461. https://doi.org/10.3201/eid2902.221796.
About the Cover

Emerging Pathogens Pose Inevitable Surprises [PDF - 915 KB - 2 pages]
B. Breedlove
EID Breedlove B. Emerging Pathogens Pose Inevitable Surprises. Emerg Infect Dis. 2023;29(2):462-463. https://doi.org/10.3201/eid2902.ac2902
AMA Breedlove B. Emerging Pathogens Pose Inevitable Surprises. Emerging Infectious Diseases. 2023;29(2):462-463. doi:10.3201/eid2902.ac2902.
APA Breedlove, B. (2023). Emerging Pathogens Pose Inevitable Surprises. Emerging Infectious Diseases, 29(2), 462-463. https://doi.org/10.3201/eid2902.ac2902.
Page created: January 23, 2023
Page updated: January 24, 2023
Page reviewed: January 24, 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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