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Molecular Epidemiology of Underreported Emerging Zoonotic Pathogen Streptococcus suis in Europe [PDF - 2.15 MB - 10 pages]
J. Brizuela et al.

Streptococcus suis, a zoonotic bacterial pathogen circulated through swine, can cause severe infections in humans. Because human S. suis infections are not notifiable in most countries, incidence is underestimated. We aimed to increase insight into the molecular epidemiology of human S. suis infections in Europe. To procure data, we surveyed 7 reference laboratories and performed a systematic review of the scientific literature. We identified 236 cases of human S. suis infection from those sources and an additional 87 by scanning gray literature. We performed whole-genome sequencing to type 46 zoonotic S. suis isolates and combined them with 28 publicly available genomes in a core-genome phylogeny. Clonal complex (CC) 1 isolates accounted for 87% of typed human infections; CC20, CC25, CC87, and CC94 also caused infections. Emergence of diverse zoonotic clades and notable severity of illness in humans support classifying S. suis infection as a notifiable condition.

EID Brizuela J, Roodsant TJ, Hasnoe Q, van der Putten B, Kozakova J, Slotved H, et al. Molecular Epidemiology of Underreported Emerging Zoonotic Pathogen Streptococcus suis in Europe. Emerg Infect Dis. 2024;30(3):413-422. https://doi.org/10.3201/eid3003.230348
AMA Brizuela J, Roodsant TJ, Hasnoe Q, et al. Molecular Epidemiology of Underreported Emerging Zoonotic Pathogen Streptococcus suis in Europe. Emerging Infectious Diseases. 2024;30(3):413-422. doi:10.3201/eid3003.230348.
APA Brizuela, J., Roodsant, T. J., Hasnoe, Q., van der Putten, B., Kozakova, J., Slotved, H....Schultsz, C. (2024). Molecular Epidemiology of Underreported Emerging Zoonotic Pathogen Streptococcus suis in Europe. Emerging Infectious Diseases, 30(3), 413-422. https://doi.org/10.3201/eid3003.230348.

Multimodal Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis among Children in Colorado, USA, 2022 [PDF - 1.73 MB - 9 pages]
K. Messacar et al.

Surveillance for emerging pathogens is critical for developing early warning systems to guide preparedness efforts for future outbreaks of associated disease. To better define the epidemiology and burden of associated respiratory disease and acute flaccid myelitis (AFM), as well as to provide actionable data for public health interventions, we developed a multimodal surveillance program in Colorado, USA, for enterovirus D68 (EV-D68). Timely local, state, and national public health outreach was possible because prospective syndromic surveillance for AFM and asthma-like respiratory illness, prospective clinical laboratory surveillance for EV-D68 among children hospitalized with respiratory illness, and retrospective wastewater surveillance led to early detection of the 2022 outbreak of EV-D68 among Colorado children. The lessons learned from developing the individual layers of this multimodal surveillance program and how they complemented and informed the other layers of surveillance for EV-D68 and AFM could be applied to other emerging pathogens and their associated diseases.

EID Messacar K, Matzinger S, Berg K, Weisbeck K, Butler M, Pysnack N, et al. Multimodal Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis among Children in Colorado, USA, 2022. Emerg Infect Dis. 2024;30(3):423-431. https://doi.org/10.3201/eid3003.231223
AMA Messacar K, Matzinger S, Berg K, et al. Multimodal Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis among Children in Colorado, USA, 2022. Emerging Infectious Diseases. 2024;30(3):423-431. doi:10.3201/eid3003.231223.
APA Messacar, K., Matzinger, S., Berg, K., Weisbeck, K., Butler, M., Pysnack, N....Dominguez, S. R. (2024). Multimodal Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis among Children in Colorado, USA, 2022. Emerging Infectious Diseases, 30(3), 423-431. https://doi.org/10.3201/eid3003.231223.

Concurrent Clade I and Clade II Monkeypox Virus Circulation, Cameroon, 1979–2022 [PDF - 2.78 MB - 12 pages]
D. D. Djuicy et al.

During 1979–2022, Cameroon recorded 32 laboratory-confirmed mpox cases among 137 suspected mpox cases identified by the national surveillance network. The highest positivity rate occurred in 2022, indicating potential mpox re-emergence in Cameroon. Both clade I (n = 12) and clade II (n = 18) monkeypox virus (MPXV) were reported, a unique feature of mpox in Cameroon. The overall case-fatality ratio of 2.2% was associated with clade II. We found mpox occurred only in the forested southern part of the country, and MPXV phylogeographic structure revealed a clear geographic separation among concurrent circulating clades. Clade I originated from eastern regions close to neighboring mpox-endemic countries in Central Africa; clade II was prevalent in western regions close to West Africa. Our findings suggest that MPXV re-emerged after a 30-year lapse and might arise from different viral reservoirs unique to ecosystems in eastern and western rainforests of Cameroon.

EID Djuicy DD, Sadeuh-Mba SA, Bilounga CN, Yonga MG, Tchatchueng-Mbougua JB, Essima GD, et al. Concurrent Clade I and Clade II Monkeypox Virus Circulation, Cameroon, 1979–2022. Emerg Infect Dis. 2024;30(3):432-443. https://doi.org/10.3201/eid3003.230861
AMA Djuicy DD, Sadeuh-Mba SA, Bilounga CN, et al. Concurrent Clade I and Clade II Monkeypox Virus Circulation, Cameroon, 1979–2022. Emerging Infectious Diseases. 2024;30(3):432-443. doi:10.3201/eid3003.230861.
APA Djuicy, D. D., Sadeuh-Mba, S. A., Bilounga, C. N., Yonga, M. G., Tchatchueng-Mbougua, J. B., Essima, G. D....Njouom, R. (2024). Concurrent Clade I and Clade II Monkeypox Virus Circulation, Cameroon, 1979–2022. Emerging Infectious Diseases, 30(3), 432-443. https://doi.org/10.3201/eid3003.230861.

Recent Changes in Patterns of Mammal Infection with Highly Pathogenic Avian Influenza A(H5N1) Virus Worldwide [PDF - 2.69 MB - 9 pages]
P. I. Plaza et al.

We reviewed information about mammals naturally infected by highly pathogenic avian influenza A virus subtype H5N1 during 2 periods: the current panzootic (2020–2023) and previous waves of infection (2003–2019). In the current panzootic, 26 countries have reported >48 mammal species infected by H5N1 virus; in some cases, the virus has affected thousands of individual animals. The geographic area and the number of species affected by the current event are considerably larger than in previous waves of infection. The most plausible source of mammal infection in both periods appears to be close contact with infected birds, including their ingestion. Some studies, especially in the current panzootic, suggest that mammal-to-mammal transmission might be responsible for some infections; some mutations found could help this avian pathogen replicate in mammals. H5N1 virus may be changing and adapting to infect mammals. Continuous surveillance is essential to mitigate the risk for a global pandemic.

EID Plaza PI, Gamarra-Toledo V, Euguí J, Lambertucci SA. Recent Changes in Patterns of Mammal Infection with Highly Pathogenic Avian Influenza A(H5N1) Virus Worldwide. Emerg Infect Dis. 2024;30(3):444-452. https://doi.org/10.3201/eid3003.231098
AMA Plaza PI, Gamarra-Toledo V, Euguí J, et al. Recent Changes in Patterns of Mammal Infection with Highly Pathogenic Avian Influenza A(H5N1) Virus Worldwide. Emerging Infectious Diseases. 2024;30(3):444-452. doi:10.3201/eid3003.231098.
APA Plaza, P. I., Gamarra-Toledo, V., Euguí, J., & Lambertucci, S. A. (2024). Recent Changes in Patterns of Mammal Infection with Highly Pathogenic Avian Influenza A(H5N1) Virus Worldwide. Emerging Infectious Diseases, 30(3), 444-452. https://doi.org/10.3201/eid3003.231098.
Research

Monitoring and Characteristics of Mpox Contacts, Virginia, USA, May–November 2022 [PDF - 733 KB - 7 pages]
E. N. Field et al.

During 2022, a global outbreak of mpox resulted primarily from human-to-human contact. The Virginia Department of Health (Richmond, VA, USA) implemented a contact tracing and symptom monitoring system for residents exposed to monkeypox virus, assessed their risk for infection, and offered interventions as needed. Among 991 contacts identified during May 1–November 1, 2022, import records were complete for 943 (95.2%), but 99 (10.0%) were not available for follow-up during symptom monitoring. Mpox developed in 28 (2.8%) persons; none were healthcare workers exposed at work (n = 275). Exposure risk category and likelihood of developing mpox were strongly associated. A total of 333 persons received >1 dose of JYENNOS (Bavarian Nordic, https://www.bavarian-nordic.com) vaccine, most (n = 295) administered after virus exposure. Median time from exposure to vaccination was 8 days. Those data tools provided crucial real-time information for public health responses and can be used as a framework for other emerging diseases.

EID Field EN, McCarty E, Saady D, Darby B. Monitoring and Characteristics of Mpox Contacts, Virginia, USA, May–November 2022. Emerg Infect Dis. 2024;30(3):453-459. https://doi.org/10.3201/eid3003.230609
AMA Field EN, McCarty E, Saady D, et al. Monitoring and Characteristics of Mpox Contacts, Virginia, USA, May–November 2022. Emerging Infectious Diseases. 2024;30(3):453-459. doi:10.3201/eid3003.230609.
APA Field, E. N., McCarty, E., Saady, D., & Darby, B. (2024). Monitoring and Characteristics of Mpox Contacts, Virginia, USA, May–November 2022. Emerging Infectious Diseases, 30(3), 453-459. https://doi.org/10.3201/eid3003.230609.

Expansion of Neisseria meningitidis Serogroup C Clonal Complex 10217 during Meningitis Outbreak, Burkina Faso, 2019 [PDF - 1.61 MB - 9 pages]
J. F. Kekeisen-Chen et al.

During January 28–May 5, 2019, a meningitis outbreak caused by Neisseria meningitidis serogroup C (NmC) occurred in Burkina Faso. Demographic and laboratory data for meningitis cases were collected through national case-based surveillance. Cerebrospinal fluid was collected and tested by culture and real-time PCR. Among 301 suspected cases reported in 6 districts, N. meningitidis was the primary pathogen detected; 103 cases were serogroup C and 13 were serogroup X. Whole-genome sequencing revealed that 18 cerebrospinal fluid specimens tested positive for NmC sequence type (ST) 10217 within clonal complex 10217, an ST responsible for large epidemics in Niger and Nigeria. Expansion of NmC ST10217 into Burkina Faso, continued NmC outbreaks in the meningitis belt of Africa since 2019, and ongoing circulation of N. meningitidis serogroup X in the region underscore the urgent need to use multivalent conjugate vaccines in regional mass vaccination campaigns to reduce further spread of those serogroups.

EID Kekeisen-Chen JF, Tarbangdo FT, Sharma S, Marasini D, Marjuki H, Kibler JL, et al. Expansion of Neisseria meningitidis Serogroup C Clonal Complex 10217 during Meningitis Outbreak, Burkina Faso, 2019. Emerg Infect Dis. 2024;30(3):460-468. https://doi.org/10.3201/eid3003.221760
AMA Kekeisen-Chen JF, Tarbangdo FT, Sharma S, et al. Expansion of Neisseria meningitidis Serogroup C Clonal Complex 10217 during Meningitis Outbreak, Burkina Faso, 2019. Emerging Infectious Diseases. 2024;30(3):460-468. doi:10.3201/eid3003.221760.
APA Kekeisen-Chen, J. F., Tarbangdo, F. T., Sharma, S., Marasini, D., Marjuki, H., Kibler, J. L....McNamara, L. A. (2024). Expansion of Neisseria meningitidis Serogroup C Clonal Complex 10217 during Meningitis Outbreak, Burkina Faso, 2019. Emerging Infectious Diseases, 30(3), 460-468. https://doi.org/10.3201/eid3003.221760.

Microsporidia (Encephalitozoon cuniculi) in Patients with Degenerative Hip and Knee Disease, Czech Republic [PDF - 1.41 MB - 9 pages]
B. Sak et al.

Total joint arthroplasty is a commonly used surgical procedure in orthopedics. Revision surgeries are required in >10% of patients mainly because of prosthetic joint infection caused by bacteria or aseptic implant loosening caused by chronic inflammation. Encephalitozoon cuniculi is a microsporidium, an obligate intracellular parasite, capable of exploiting migrating proinflammatory immune cells for dissemination within the host. We used molecular detection methods to evaluate the incidence of E. cuniculi among patients who had total hip or knee arthroplasty revision. Out of 49 patients, E. cuniculi genotypes I, II, or III were confirmed in joint samples from 3 men and 2 women who had implant loosening. Understanding the risks associated with the presence of microsporidia in periprosthetic joint infections is essential for proper management of arthroplasty. Furthermore, E. cuniculi should be considered a potential contributing cause of joint inflammation and arthrosis.

EID Sak B, Gottliebová P, Nyčová E, Holubová N, Fenclová J, Kicia M, et al. Microsporidia (Encephalitozoon cuniculi) in Patients with Degenerative Hip and Knee Disease, Czech Republic. Emerg Infect Dis. 2024;30(3):469-477. https://doi.org/10.3201/eid3003.231263
AMA Sak B, Gottliebová P, Nyčová E, et al. Microsporidia (Encephalitozoon cuniculi) in Patients with Degenerative Hip and Knee Disease, Czech Republic. Emerging Infectious Diseases. 2024;30(3):469-477. doi:10.3201/eid3003.231263.
APA Sak, B., Gottliebová, P., Nyčová, E., Holubová, N., Fenclová, J., Kicia, M....Kváč, M. (2024). Microsporidia (Encephalitozoon cuniculi) in Patients with Degenerative Hip and Knee Disease, Czech Republic. Emerging Infectious Diseases, 30(3), 469-477. https://doi.org/10.3201/eid3003.231263.

Population-Based Evaluation of Vaccine Effectiveness against SARS-CoV-2 Infection, Severe Illness, and Death, Taiwan [PDF - 5.13 MB - 12 pages]
C. Lee et al.

Taiwan provided several COVID-19 vaccine platforms: mRNA (BNT162b2, mRNA-1273), adenoviral vector-based (AZD1222), and protein subunit (MVC-COV1901). After Taiwan shifted from its zero-COVID strategy in April 2022, population-based evaluation of vaccine effectiveness (VE) became possible. We conducted an observational cohort study of 21,416,151 persons to examine VE against SARS-CoV-2 infection, moderate and severe illness, and death during March 22, 2021–September 30, 2022. After adjusting for age and sex, we found that persons who completed 3 vaccine doses (2 primary, 1 booster) or received MVC-COV1901 as the primary series had the lowest hospitalization incidence (0.04–0.20 cases/100,000 person-days). We also found 95.8% VE against hospitalization for 3 doses of BNT162b2, 91.0% for MVC-COV1901, 81.8% for mRNA-1273, and 65.7% for AZD1222, which had the lowest overall VE. Our findings indicated that protein subunit vaccines provide similar protection against SARS-CoV-2­­–associated hospitalization as mRNA vaccines and can inform mix-and-match vaccine selection in other countries.

EID Lee C, Kuo H, Liu Y, Chuang J, Chou J. Population-Based Evaluation of Vaccine Effectiveness against SARS-CoV-2 Infection, Severe Illness, and Death, Taiwan. Emerg Infect Dis. 2024;30(3):478-489. https://doi.org/10.3201/eid3003.230893
AMA Lee C, Kuo H, Liu Y, et al. Population-Based Evaluation of Vaccine Effectiveness against SARS-CoV-2 Infection, Severe Illness, and Death, Taiwan. Emerging Infectious Diseases. 2024;30(3):478-489. doi:10.3201/eid3003.230893.
APA Lee, C., Kuo, H., Liu, Y., Chuang, J., & Chou, J. (2024). Population-Based Evaluation of Vaccine Effectiveness against SARS-CoV-2 Infection, Severe Illness, and Death, Taiwan. Emerging Infectious Diseases, 30(3), 478-489. https://doi.org/10.3201/eid3003.230893.

Effect of Pneumococcal Conjugate Vaccine on Pneumonia Incidence Rates among Children 2–59 Months of Age, Mongolia, 2015–2021 [PDF - 1.38 MB - 9 pages]
C. von Mollendorf et al.

Starting in June 2016, the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced into the routine immunization program of Mongolia by using a 2+1 dosing schedule, phased by district. We used prospective hospital surveillance to evaluate the vaccine’s effect on pneumonia incidence rates among children 2–59 months of age over a 6-year period. Of 17,607 children with pneumonia, overall adjusted incidence rate ratios showed decreased primary endpoint pneumonia, very severe pneumonia, and probable pneumococcal pneumonia until June 2021. Results excluding and including the COVID-19 pandemic period were similar. Pneumonia declined in 3 districts that introduced PCV13 with catch-up campaigns but not in the 1 district that did not. After PCV13 introduction, vaccine-type pneumococcal carriage prevalence decreased by 44% and nonvaccine-type carriage increased by 49%. After PCV13 introduction in Mongolia, the incidence of more specific pneumonia endpoints declined in children 2–59 months of age; additional benefits were conferred by catch-up campaigns.

EID von Mollendorf C, Ulziibayar M, Nguyen CD, Batsaikhan P, Suuri B, Luvsantseren D, et al. Effect of Pneumococcal Conjugate Vaccine on Pneumonia Incidence Rates among Children 2–59 Months of Age, Mongolia, 2015–2021. Emerg Infect Dis. 2024;30(3):490-498. https://doi.org/10.3201/eid3003.230864
AMA von Mollendorf C, Ulziibayar M, Nguyen CD, et al. Effect of Pneumococcal Conjugate Vaccine on Pneumonia Incidence Rates among Children 2–59 Months of Age, Mongolia, 2015–2021. Emerging Infectious Diseases. 2024;30(3):490-498. doi:10.3201/eid3003.230864.
APA von Mollendorf, C., Ulziibayar, M., Nguyen, C. D., Batsaikhan, P., Suuri, B., Luvsantseren, D....Mulholland, E. (2024). Effect of Pneumococcal Conjugate Vaccine on Pneumonia Incidence Rates among Children 2–59 Months of Age, Mongolia, 2015–2021. Emerging Infectious Diseases, 30(3), 490-498. https://doi.org/10.3201/eid3003.230864.

Spatial Analysis of Drug-Susceptible and Multidrug-Resistant Cases of Tuberculosis, Ho Chi Minh City, Vietnam, 2020–2023 [PDF - 3.16 MB - 11 pages]
R. Spies et al.

We characterized the spatial distribution of drug-susceptible (DS) and multidrug-resistant (MDR) tuberculosis (TB) cases in Ho Chi Minh City, Vietnam, a major metropolis in southeastern Asia, and explored demographic and socioeconomic factors associated with local TB burden. Hot spots of DS and MDR TB incidence were observed in the central parts of Ho Chi Minh City, and substantial heterogeneity was observed across wards. Positive spatial autocorrelation was observed for both DS TB and MDR TB. Ward-level TB incidence was associated with HIV prevalence and the male proportion of the population. No ward-level demographic and socioeconomic indicators were associated with MDR TB case count relative to total TB case count. Our findings might inform spatially targeted TB control strategies and provide insights for generating hypotheses about the nature of the relationship between DS and MDR TB in Ho Chi Minh City and the wider southeastern region of Asia.

EID Spies R, Hong HN, Trieu PP, Lan LK, Lan K, Hue N, et al. Spatial Analysis of Drug-Susceptible and Multidrug-Resistant Cases of Tuberculosis, Ho Chi Minh City, Vietnam, 2020–2023. Emerg Infect Dis. 2024;30(3):499-509. https://doi.org/10.3201/eid3003.231309
AMA Spies R, Hong HN, Trieu PP, et al. Spatial Analysis of Drug-Susceptible and Multidrug-Resistant Cases of Tuberculosis, Ho Chi Minh City, Vietnam, 2020–2023. Emerging Infectious Diseases. 2024;30(3):499-509. doi:10.3201/eid3003.231309.
APA Spies, R., Hong, H. N., Trieu, P. P., Lan, L. K., Lan, K., Hue, N....Walker, T. M. (2024). Spatial Analysis of Drug-Susceptible and Multidrug-Resistant Cases of Tuberculosis, Ho Chi Minh City, Vietnam, 2020–2023. Emerging Infectious Diseases, 30(3), 499-509. https://doi.org/10.3201/eid3003.231309.

Medscape CME Activity
Disseminated Leishmaniasis, a Severe Form of Leishmania braziliensis Infection [PDF - 1004 KB - 9 pages]
P. Machado et al.

Disseminated leishmaniasis (DL) is an emergent severe disease manifesting with multiple lesions. To determine the relationship between immune response and clinical and therapeutic outcomes, we studied 101 DL and 101 cutaneous leishmaniasis (CL) cases and determined cytokines and chemokines in supernatants of mononuclear cells stimulated with leishmania antigen. Patients were treated with meglumine antimoniate (20 mg/kg) for 20 days (CL) or 30 days (DL); 19 DL patients were instead treated with amphotericin B, miltefosine, or miltefosine and meglumine antimoniate. High levels of chemokine ligand 9 were associated with more severe DL. The cure rate for meglumine antimoniate was low for both DL (44%) and CL (60%), but healing time was longer in DL (p = 0.003). The lowest cure rate (22%) was found in DL patients with >100 lesions. However, meglumine antimoniate/miltefosine treatment cured all DL patients who received it; therefore, that combination should be considered as first choice therapy.

EID Machado P, Lago A, Cardoso TM, Magalhaes A, Carvalho LP, Lago T, et al. Disseminated Leishmaniasis, a Severe Form of Leishmania braziliensis Infection. Emerg Infect Dis. 2024;30(3):510-518. https://doi.org/10.3201/eid3003.230786
AMA Machado P, Lago A, Cardoso TM, et al. Disseminated Leishmaniasis, a Severe Form of Leishmania braziliensis Infection. Emerging Infectious Diseases. 2024;30(3):510-518. doi:10.3201/eid3003.230786.
APA Machado, P., Lago, A., Cardoso, T. M., Magalhaes, A., Carvalho, L. P., Lago, T....Carvalho, E. M. (2024). Disseminated Leishmaniasis, a Severe Form of Leishmania braziliensis Infection. Emerging Infectious Diseases, 30(3), 510-518. https://doi.org/10.3201/eid3003.230786.

Systematic Review of Scales for Measuring Infectious Disease–Related Stigma [PDF - 1.48 MB - 11 pages]
A. Paterson et al.

Infectious disease outbreaks are associated with substantial stigma, which can have negative effects on affected persons and communities and on outbreak control. Thus, measuring stigma in a standardized and validated manner early in an outbreak is critical to disease control. We reviewed existing scales used to assess stigma during outbreaks. Our findings show that many different scales have been developed, but few have been used more than once, have been adequately validated, or have been tested in different disease and geographic contexts. We found that scales were usually developed too slowly to be informative early during an outbreak and were published a median of 2 years after the first case of an outbreak. A rigorously developed, transferable stigma scale is needed to assess and direct responses to stigma during infectious disease outbreaks.

EID Paterson A, Cheyne A, Jones B, Schilling S, Sigfrid L, Stolow J, et al. Systematic Review of Scales for Measuring Infectious Disease–Related Stigma. Emerg Infect Dis. 2024;30(3):519-529. https://doi.org/10.3201/eid3003.230934
AMA Paterson A, Cheyne A, Jones B, et al. Systematic Review of Scales for Measuring Infectious Disease–Related Stigma. Emerging Infectious Diseases. 2024;30(3):519-529. doi:10.3201/eid3003.230934.
APA Paterson, A., Cheyne, A., Jones, B., Schilling, S., Sigfrid, L., Stolow, J....Rojek, A. (2024). Systematic Review of Scales for Measuring Infectious Disease–Related Stigma. Emerging Infectious Diseases, 30(3), 519-529. https://doi.org/10.3201/eid3003.230934.

Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021–2022 [PDF - 2.46 MB - 9 pages]
J. W. Keck et al.

Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour composite wastewater samples 2–4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021–February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed variable correlation with clinical test data; we observed the strongest correlations in the LTCFs with the most positive clinical tests (n = 45 and n = 58). Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance.

EID Keck JW, Adatorwovor R, Liversedge M, Mijotavich B, Olsson C, Strike WD, et al. Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021–2022. Emerg Infect Dis. 2024;30(3):530-538. https://doi.org/10.3201/eid3003.230888
AMA Keck JW, Adatorwovor R, Liversedge M, et al. Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021–2022. Emerging Infectious Diseases. 2024;30(3):530-538. doi:10.3201/eid3003.230888.
APA Keck, J. W., Adatorwovor, R., Liversedge, M., Mijotavich, B., Olsson, C., Strike, W. D....Berry, S. M. (2024). Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021–2022. Emerging Infectious Diseases, 30(3), 530-538. https://doi.org/10.3201/eid3003.230888.

Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection [PDF - 1.31 MB - 9 pages]
Q. M. Vu et al.

This study aimed to estimate the incidence rates of post–COVID-19 fatigue and chronic fatigue and to quantify the additional incident fatigue caused by COVID-19. We analyzed electronic health records data of 4,589 patients with confirmed COVID-19 during February 2020–February 2021 who were followed for a median of 11.4 (interquartile range 7.8–15.5) months and compared them to data from 9,022 propensity score–matched non–COVID-19 controls. Among COVID-19 patients (15% hospitalized for acute COVID-19), the incidence rate of fatigue was 10.2/100 person-years and the rate of chronic fatigue was 1.8/100 person-years. Compared with non–COVID-19 controls, the hazard ratios were 1.68 (95% CI 1.48–1.92) for fatigue and 4.32 (95% CI 2.90–6.43) for chronic fatigue. The observed association between COVID-19 and the significant increase in the incidence of fatigue and chronic fatigue reinforces the need for public health actions to prevent SARS-CoV-2 infections.

EID Vu QM, Fitzpatrick AL, Cope JR, Bertolli J, Sotoodehnia N, West T, et al. Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection. Emerg Infect Dis. 2024;30(3):539-547. https://doi.org/10.3201/eid3003.231194
AMA Vu QM, Fitzpatrick AL, Cope JR, et al. Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection. Emerging Infectious Diseases. 2024;30(3):539-547. doi:10.3201/eid3003.231194.
APA Vu, Q. M., Fitzpatrick, A. L., Cope, J. R., Bertolli, J., Sotoodehnia, N., West, T....Unger, E. R. (2024). Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection. Emerging Infectious Diseases, 30(3), 539-547. https://doi.org/10.3201/eid3003.231194.

Geographic Variation and Environmental Predictors of Nontuberculous Mycobacteria in Laboratory Surveillance, Virginia, USA, 2021–2023 [PDF - 1.44 MB - 7 pages]
B. Mullen et al.

Because epidemiologic and environmental risk factors for nontuberculous mycobacteria (NTM) have been reported only infrequently, little information exists about those factors. The state of Virginia, USA, requires certain ecologic features to be included in reports to the Virginia Department of Health, presenting a unique opportunity to study those variables. We analyzed laboratory reports of Mycobacterium avium complex (MAC) and M. abscessus infections in Virginia during 2021–2023. MAC/M. abscessus was isolated from 6.19/100,000 persons, and 2.37/100,000 persons had MAC/M. abscessus lung disease. M. abscessus accounted for 17.4% and MAC for 82.6% of cases. Saturated vapor pressure was associated with MAC/M. abscessus prevalence (prevalence ratio 1.414, 95% CI 1.011–1.980; p = 0.043). Self-supplied water use was a protective factor (incidence rate ratio 0.304, 95% CI 0.098–0.950; p = 0.041). Our findings suggest that a better understanding of geographic clustering and environmental water exposures could help develop future targeted prevention and control efforts.

EID Mullen B, Houpt ER, Colston J, Becker L, Johnson S, Young L, et al. Geographic Variation and Environmental Predictors of Nontuberculous Mycobacteria in Laboratory Surveillance, Virginia, USA, 2021–2023. Emerg Infect Dis. 2024;30(3):548-554. https://doi.org/10.3201/eid3003.231162
AMA Mullen B, Houpt ER, Colston J, et al. Geographic Variation and Environmental Predictors of Nontuberculous Mycobacteria in Laboratory Surveillance, Virginia, USA, 2021–2023. Emerging Infectious Diseases. 2024;30(3):548-554. doi:10.3201/eid3003.231162.
APA Mullen, B., Houpt, E. R., Colston, J., Becker, L., Johnson, S., Young, L....Heysell, S. K. (2024). Geographic Variation and Environmental Predictors of Nontuberculous Mycobacteria in Laboratory Surveillance, Virginia, USA, 2021–2023. Emerging Infectious Diseases, 30(3), 548-554. https://doi.org/10.3201/eid3003.231162.
Dispatches

Taenia martis Neurocysticercosis-Like Lesion in Child, Associated with Local Source, the Netherlands [PDF - 1.81 MB - 5 pages]
H. Eggink et al.

A neurocysticercosis-like lesion in an 11-year-old boy in the Netherlands was determined to be caused by the zoonotic Taenia martis tapeworm. Subsequent testing revealed that 15% of wild martens tested in that region were infected with T. martis tapeworms with 100% genetic similarity; thus, the infection source was most likely local.

EID Eggink H, Maas M, van den Brand J, Dekker J, Franssen F, Hoving EW, et al. Taenia martis Neurocysticercosis-Like Lesion in Child, Associated with Local Source, the Netherlands. Emerg Infect Dis. 2024;30(3):555-559. https://doi.org/10.3201/eid3003.231402
AMA Eggink H, Maas M, van den Brand J, et al. Taenia martis Neurocysticercosis-Like Lesion in Child, Associated with Local Source, the Netherlands. Emerging Infectious Diseases. 2024;30(3):555-559. doi:10.3201/eid3003.231402.
APA Eggink, H., Maas, M., van den Brand, J., Dekker, J., Franssen, F., Hoving, E. W....Schölvinck, E. H. (2024). Taenia martis Neurocysticercosis-Like Lesion in Child, Associated with Local Source, the Netherlands. Emerging Infectious Diseases, 30(3), 555-559. https://doi.org/10.3201/eid3003.231402.

Newly Identified Mycobacterium africanum Lineage 10, Central Africa [PDF - 1.20 MB - 4 pages]
C. Guyeux et al.

Analysis of genome sequencing data from >100,000 genomes of Mycobacterium tuberculosis complex using TB-Annotator software revealed a previously unknown lineage, proposed name L10, in central Africa. Phylogenetic reconstruction suggests L10 could represent a missing link in the evolutionary and geographic migration histories of M. africanum.

EID Guyeux C, Senelle G, Le Meur A, Supply P, Gaudin C, Phelan JE, et al. Newly Identified Mycobacterium africanum Lineage 10, Central Africa. Emerg Infect Dis. 2024;30(3):560-563. https://doi.org/10.3201/eid3003.231466
AMA Guyeux C, Senelle G, Le Meur A, et al. Newly Identified Mycobacterium africanum Lineage 10, Central Africa. Emerging Infectious Diseases. 2024;30(3):560-563. doi:10.3201/eid3003.231466.
APA Guyeux, C., Senelle, G., Le Meur, A., Supply, P., Gaudin, C., Phelan, J. E....Refrégier, G. (2024). Newly Identified Mycobacterium africanum Lineage 10, Central Africa. Emerging Infectious Diseases, 30(3), 560-563. https://doi.org/10.3201/eid3003.231466.

Delayed Diagnosis of Locally Acquired Lyme Disease, Central North Carolina, USA [PDF - 763 KB - 4 pages]
R. M. Boyce et al.

Healthcare providers in North Carolina, USA, have limited experience diagnosing and managing Lyme disease because few cases occur annually statewide. We outline the prolonged diagnostic course for a patient with locally acquired Lyme disease in North Carolina. This case highlights the need for greater awareness and professional education.

EID Boyce RM, Pretsch P, Tyrlik K, Schulz A, Giandomenico DA, Barbarin AM, et al. Delayed Diagnosis of Locally Acquired Lyme Disease, Central North Carolina, USA. Emerg Infect Dis. 2024;30(3):564-567. https://doi.org/10.3201/eid3003.231302
AMA Boyce RM, Pretsch P, Tyrlik K, et al. Delayed Diagnosis of Locally Acquired Lyme Disease, Central North Carolina, USA. Emerging Infectious Diseases. 2024;30(3):564-567. doi:10.3201/eid3003.231302.
APA Boyce, R. M., Pretsch, P., Tyrlik, K., Schulz, A., Giandomenico, D. A., Barbarin, A. M....Williams, C. (2024). Delayed Diagnosis of Locally Acquired Lyme Disease, Central North Carolina, USA. Emerging Infectious Diseases, 30(3), 564-567. https://doi.org/10.3201/eid3003.231302.

Bedaquiline Resistance after Effective Treatment of Multidrug-Resistant Tuberculosis, Namibia [PDF - 892 KB - 4 pages]
G. Günther et al.

Bedaquiline is currently a key drug for treating multidrug-resistant or rifampin-resistant tuberculosis. We report and discuss the unusual development of resistance to bedaquiline in a teenager in Namibia, despite an optimal background regimen and adherence. The report highlights the risk for bedaquiline resistance development and the need for rapid drug-resistance testing.

EID Günther G, Mhuulu L, Diergaardt A, Dreyer V, Moses M, Anyolo K, et al. Bedaquiline Resistance after Effective Treatment of Multidrug-Resistant Tuberculosis, Namibia. Emerg Infect Dis. 2024;30(3):568-571. https://doi.org/10.3201/eid3003.240134
AMA Günther G, Mhuulu L, Diergaardt A, et al. Bedaquiline Resistance after Effective Treatment of Multidrug-Resistant Tuberculosis, Namibia. Emerging Infectious Diseases. 2024;30(3):568-571. doi:10.3201/eid3003.240134.
APA Günther, G., Mhuulu, L., Diergaardt, A., Dreyer, V., Moses, M., Anyolo, K....Nepolo, E. (2024). Bedaquiline Resistance after Effective Treatment of Multidrug-Resistant Tuberculosis, Namibia. Emerging Infectious Diseases, 30(3), 568-571. https://doi.org/10.3201/eid3003.240134.

High Prevalence of Echinostoma mekongi Infection in Schoolchildren and Adults, Kandal Province, Cambodia [PDF - 2.14 MB - 5 pages]
B. Jung et al.

A high prevalence of Echinostoma mekongi infection (13.9%; 260/1,876) was found among schoolchildren and adults in Kandal Province, Cambodia, by fecal examination, worm expulsion, and molecular analysis of cox1 and nd1 genes. The source of infection was consumption of Pila sp. snails, a finding confirmed morphologically and molecularly.

EID Jung B, Chang T, Ryoo S, Hong S, Lee J, Hong S, et al. High Prevalence of Echinostoma mekongi Infection in Schoolchildren and Adults, Kandal Province, Cambodia. Emerg Infect Dis. 2024;30(3):572-576. https://doi.org/10.3201/eid3003.240001
AMA Jung B, Chang T, Ryoo S, et al. High Prevalence of Echinostoma mekongi Infection in Schoolchildren and Adults, Kandal Province, Cambodia. Emerging Infectious Diseases. 2024;30(3):572-576. doi:10.3201/eid3003.240001.
APA Jung, B., Chang, T., Ryoo, S., Hong, S., Lee, J., Hong, S....Chai, J. (2024). High Prevalence of Echinostoma mekongi Infection in Schoolchildren and Adults, Kandal Province, Cambodia. Emerging Infectious Diseases, 30(3), 572-576. https://doi.org/10.3201/eid3003.240001.

Potentially Zoonotic Enteric Infections in Gorillas and Chimpanzees, Cameroon and Tanzania [PDF - 286 KB - 4 pages]
E. K. Strahan et al.

Despite zoonotic potential, data are lacking on enteric infection diversity in wild apes. We employed a novel molecular diagnostic platform to detect enteric infections in wild chimpanzees and gorillas. Prevalent Cryptosporidium parvum, adenovirus, and diarrheagenic Escherichia coli across divergent sites and species demonstrates potential widespread circulation among apes in Africa.

EID Strahan EK, Witherbee J, Bergl R, Lonsdorf EV, Mwacha D, Mjungu D, et al. Potentially Zoonotic Enteric Infections in Gorillas and Chimpanzees, Cameroon and Tanzania. Emerg Infect Dis. 2024;30(3):577-580. https://doi.org/10.3201/eid3003.230318
AMA Strahan EK, Witherbee J, Bergl R, et al. Potentially Zoonotic Enteric Infections in Gorillas and Chimpanzees, Cameroon and Tanzania. Emerging Infectious Diseases. 2024;30(3):577-580. doi:10.3201/eid3003.230318.
APA Strahan, E. K., Witherbee, J., Bergl, R., Lonsdorf, E. V., Mwacha, D., Mjungu, D....Gillespie, T. R. (2024). Potentially Zoonotic Enteric Infections in Gorillas and Chimpanzees, Cameroon and Tanzania. Emerging Infectious Diseases, 30(3), 577-580. https://doi.org/10.3201/eid3003.230318.

Biphasic MERS-CoV Incidence in Nomadic Dromedaries with Putative Transmission to Humans, Kenya, 2022–2023 [PDF - 956 KB - 5 pages]
B. Ogoti et al.

Middle East respiratory syndrome coronavirus (MERS-CoV) is endemic in dromedaries in Africa, but camel-to-human transmission is limited. Sustained 12-month sampling of dromedaries in a Kenya abattoir hub showed biphasic MERS-CoV incidence; peak detections occurred in October 2022 and February 2023. Dromedary-exposed abattoir workers (7/48) had serologic signs of previous MERS-CoV exposure.

EID Ogoti B, Riitho V, Wildemann J, Mutono N, Tesch J, Rodon J, et al. Biphasic MERS-CoV Incidence in Nomadic Dromedaries with Putative Transmission to Humans, Kenya, 2022–2023. Emerg Infect Dis. 2024;30(3):581-585. https://doi.org/10.3201/eid3003.231488
AMA Ogoti B, Riitho V, Wildemann J, et al. Biphasic MERS-CoV Incidence in Nomadic Dromedaries with Putative Transmission to Humans, Kenya, 2022–2023. Emerging Infectious Diseases. 2024;30(3):581-585. doi:10.3201/eid3003.231488.
APA Ogoti, B., Riitho, V., Wildemann, J., Mutono, N., Tesch, J., Rodon, J....Müller, M. A. (2024). Biphasic MERS-CoV Incidence in Nomadic Dromedaries with Putative Transmission to Humans, Kenya, 2022–2023. Emerging Infectious Diseases, 30(3), 581-585. https://doi.org/10.3201/eid3003.231488.

Highly Pathogenic Avian Influenza A(H5N1) Virus Clade 2.3.4.4b in Domestic Ducks, Indonesia, 2022 [PDF - 1002 KB - 5 pages]
H. Wibawa et al.

Highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b viruses were isolated from domestic ducks in South Kalimantan, Indonesia, during April 2022. The viruses were genetically similar to those detected in East Asia during 2021–2022. Molecular surveillance of wild birds is needed to detect potential pandemic threats from avian influenza virus.

EID Wibawa H, Wibowo P, Supriyadi A, Lestari L, Silaban J, Fuadi A, et al. Highly Pathogenic Avian Influenza A(H5N1) Virus Clade 2.3.4.4b in Domestic Ducks, Indonesia, 2022. Emerg Infect Dis. 2024;30(3):586-590. https://doi.org/10.3201/eid3003.230973
AMA Wibawa H, Wibowo P, Supriyadi A, et al. Highly Pathogenic Avian Influenza A(H5N1) Virus Clade 2.3.4.4b in Domestic Ducks, Indonesia, 2022. Emerging Infectious Diseases. 2024;30(3):586-590. doi:10.3201/eid3003.230973.
APA Wibawa, H., Wibowo, P., Supriyadi, A., Lestari, L., Silaban, J., Fuadi, A....Zainuddin, N. (2024). Highly Pathogenic Avian Influenza A(H5N1) Virus Clade 2.3.4.4b in Domestic Ducks, Indonesia, 2022. Emerging Infectious Diseases, 30(3), 586-590. https://doi.org/10.3201/eid3003.230973.

Emergence of Thelaziosis Caused by Thelazia callipaeda in Dogs and Cats, United States [PDF - 1.21 MB - 4 pages]
R. Manoj et al.

We report 2 autochthonous feline thelaziosis cases caused by the eyeworm Thelazia callipaeda and discuss the spread among dogs in the northeastern United States. Phylogenetic analysis suggests the parasite was introduced from Europe. Adopting a One Health approach is needed to limit further spread of T. callipaeda eyeworms in North America.

EID Manoj R, White H, Young R, Brown CE, Wilcox R, Otranto D, et al. Emergence of Thelaziosis Caused by Thelazia callipaeda in Dogs and Cats, United States. Emerg Infect Dis. 2024;30(3):591-594. https://doi.org/10.3201/eid3003.230700
AMA Manoj R, White H, Young R, et al. Emergence of Thelaziosis Caused by Thelazia callipaeda in Dogs and Cats, United States. Emerging Infectious Diseases. 2024;30(3):591-594. doi:10.3201/eid3003.230700.
APA Manoj, R., White, H., Young, R., Brown, C. E., Wilcox, R., Otranto, D....Lejeune, M. (2024). Emergence of Thelaziosis Caused by Thelazia callipaeda in Dogs and Cats, United States. Emerging Infectious Diseases, 30(3), 591-594. https://doi.org/10.3201/eid3003.230700.
Research Letters

Burkholderia pseudomallei Bacteria in Ornamental Fish Tanks, Vientiane, Laos, 2023 [PDF - 256 KB - 2 pages]
T. Venkatesan et al.

In 2019, a melioidosis case in Maryland, USA, was shown to have been acquired from an ornamental fish tank contaminated with Burkholderia pseudomallei bacteria, likely derived from Southeast Asia. We investigated the presence of B. pseudomallei in ornamental fish tanks in the endemic area of Vientiane, Laos.

EID Venkatesan T, Siritana V, Silisouk J, Roberts T, Robinson MT, Dance D. Burkholderia pseudomallei Bacteria in Ornamental Fish Tanks, Vientiane, Laos, 2023. Emerg Infect Dis. 2024;30(3):599-600. https://doi.org/10.3201/eid3003.231674
AMA Venkatesan T, Siritana V, Silisouk J, et al. Burkholderia pseudomallei Bacteria in Ornamental Fish Tanks, Vientiane, Laos, 2023. Emerging Infectious Diseases. 2024;30(3):599-600. doi:10.3201/eid3003.231674.
APA Venkatesan, T., Siritana, V., Silisouk, J., Roberts, T., Robinson, M. T., & Dance, D. (2024). Burkholderia pseudomallei Bacteria in Ornamental Fish Tanks, Vientiane, Laos, 2023. Emerging Infectious Diseases, 30(3), 599-600. https://doi.org/10.3201/eid3003.231674.

Staphylococcus succinus Infective Endocarditis, France [PDF - 285 KB - 4 pages]
L. Ruffier d’Epenoux et al.

Infective endocarditis is a rare condition in humans and is associated with high illness and death rates. We describe a case of infective endocarditis caused by Staphylococcus succinus bacteria in France. We used several techniques for susceptibility testing for this case to determine the oxacillin profile.

EID Ruffier d’Epenoux L, Fayoux E, Laurent F, Bémer P, Lecomte R, Le Tourneau T, et al. Staphylococcus succinus Infective Endocarditis, France. Emerg Infect Dis. 2024;30(3):601-603. https://doi.org/10.3201/eid3003.230986
AMA Ruffier d’Epenoux L, Fayoux E, Laurent F, et al. Staphylococcus succinus Infective Endocarditis, France. Emerging Infectious Diseases. 2024;30(3):601-603. doi:10.3201/eid3003.230986.
APA Ruffier d’Epenoux, L., Fayoux, E., Laurent, F., Bémer, P., Lecomte, R., Le Tourneau, T....Corvec, S. (2024). Staphylococcus succinus Infective Endocarditis, France. Emerging Infectious Diseases, 30(3), 601-603. https://doi.org/10.3201/eid3003.230986.

Inadvertent Platelet Transfusion from Monkeypox Virus–Infected Donor to Recipient, Thailand, 2023 [PDF - 668 KB - 3 pages]
J. Puenpa et al.

In Thailand, platelet product from a blood donor was transfused to a recipient who had dengue. Two days later, the donor was confirmed to have monkeypox virus infection. Monkeypox virus DNA was undetectable in recipient specimens up to 2 weeks after transfusion. The recipient remained asymptomatic at 4 weeks of monitoring.

EID Puenpa J, Intharasongkroh D, Vongpunsawad S, Chaiwanichsiri D, Poovorawan Y. Inadvertent Platelet Transfusion from Monkeypox Virus–Infected Donor to Recipient, Thailand, 2023. Emerg Infect Dis. 2024;30(3):603-605. https://doi.org/10.3201/eid3003.231539
AMA Puenpa J, Intharasongkroh D, Vongpunsawad S, et al. Inadvertent Platelet Transfusion from Monkeypox Virus–Infected Donor to Recipient, Thailand, 2023. Emerging Infectious Diseases. 2024;30(3):603-605. doi:10.3201/eid3003.231539.
APA Puenpa, J., Intharasongkroh, D., Vongpunsawad, S., Chaiwanichsiri, D., & Poovorawan, Y. (2024). Inadvertent Platelet Transfusion from Monkeypox Virus–Infected Donor to Recipient, Thailand, 2023. Emerging Infectious Diseases, 30(3), 603-605. https://doi.org/10.3201/eid3003.231539.

Detection of Invasive Anopheles stephensi Mosquitoes through Molecular Surveillance, Ghana [PDF - 763 KB - 4 pages]
Y. A. Afrane et al.

The invasive Anopheles stephensi mosquito has rapidly expanded in range in Africa over the past decade. Consistent with World Health Organization guidelines, routine entomologic surveillance of malaria vectors in Accra, Ghana, now includes morphologic and molecular surveillance of An. stephensi mosquitoes. We report detection of An. stephensi mosquitoes in Ghana.

EID Afrane YA, Abdulai A, Mohammed AR, Akuamoah-Boateng Y, Owusu-Asenso CM, Sraku IK, et al. Detection of Invasive Anopheles stephensi Mosquitoes through Molecular Surveillance, Ghana. Emerg Infect Dis. 2024;30(3):605-608. https://doi.org/10.3201/eid3003.231638
AMA Afrane YA, Abdulai A, Mohammed AR, et al. Detection of Invasive Anopheles stephensi Mosquitoes through Molecular Surveillance, Ghana. Emerging Infectious Diseases. 2024;30(3):605-608. doi:10.3201/eid3003.231638.
APA Afrane, Y. A., Abdulai, A., Mohammed, A. R., Akuamoah-Boateng, Y., Owusu-Asenso, C. M., Sraku, I. K....Lobo, N. F. (2024). Detection of Invasive Anopheles stephensi Mosquitoes through Molecular Surveillance, Ghana. Emerging Infectious Diseases, 30(3), 605-608. https://doi.org/10.3201/eid3003.231638.

Streptobacillus moniliformis and IgM and IgG Immune Response in Patient with Endocarditis [PDF - 686 KB - 3 pages]
P. Mathé et al.

We describe a case of endocarditis caused by Streptobacillus moniliformis bacteria, a known cause of rat-bite fever, in a 32-year-old woman with pet rats in Germany. The patient had a strong serologic response, with high IgM and IgG titers. Serologic analysis is a promising tool to identify S. moniliformis bacterial infection.

EID Mathé P, Schmidt K, Schindler V, Fawzy A, Schultze T, Voll RE, et al. Streptobacillus moniliformis and IgM and IgG Immune Response in Patient with Endocarditis. Emerg Infect Dis. 2024;30(3):608-610. https://doi.org/10.3201/eid3003.230917
AMA Mathé P, Schmidt K, Schindler V, et al. Streptobacillus moniliformis and IgM and IgG Immune Response in Patient with Endocarditis. Emerging Infectious Diseases. 2024;30(3):608-610. doi:10.3201/eid3003.230917.
APA Mathé, P., Schmidt, K., Schindler, V., Fawzy, A., Schultze, T., Voll, R. E....Eisenberg, T. (2024). Streptobacillus moniliformis and IgM and IgG Immune Response in Patient with Endocarditis. Emerging Infectious Diseases, 30(3), 608-610. https://doi.org/10.3201/eid3003.230917.

Source Tracing of Leishmania donovani in Emerging Foci of Visceral Leishmaniasis, Western Nepal [PDF - 570 KB - 3 pages]
P. Monsieurs et al.

We sequenced Leishmania donovani genomes in blood samples collected in emerging foci of visceral leishmaniasis in western Nepal. We detected lineages very different from the preelimination main parasite population, including a new lineage and a rare one previously reported in eastern Nepal. Our findings underscore the need for genomic surveillance.

EID Monsieurs P, Cloots K, Uranw S, Banjara M, Ghimire P, Burza S, et al. Source Tracing of Leishmania donovani in Emerging Foci of Visceral Leishmaniasis, Western Nepal. Emerg Infect Dis. 2024;30(3):611-613. https://doi.org/10.3201/eid3003.231160
AMA Monsieurs P, Cloots K, Uranw S, et al. Source Tracing of Leishmania donovani in Emerging Foci of Visceral Leishmaniasis, Western Nepal. Emerging Infectious Diseases. 2024;30(3):611-613. doi:10.3201/eid3003.231160.
APA Monsieurs, P., Cloots, K., Uranw, S., Banjara, M., Ghimire, P., Burza, S....Domagalska, M. (2024). Source Tracing of Leishmania donovani in Emerging Foci of Visceral Leishmaniasis, Western Nepal. Emerging Infectious Diseases, 30(3), 611-613. https://doi.org/10.3201/eid3003.231160.

Enterocytozoon bieneusi Infection after Hematopoietic Stem Cell Transplant in Child, Argentina [PDF - 925 KB - 4 pages]
C. Mena et al.

We report a case of Enterocytozoon bieneusi infection in a pediatric hematopoietic stem cell transplant recipient in Argentina. Spores were visualized in feces using Calcofluor White and modified trichrome stainings. PCR and sequencing identified E. bieneusi genotype D in fecal samples and liver samples, confirming extraintestinal dissemination of the parasite.

EID Mena C, Garófalo M, Perazzo J, Epelbaum C, Castro G, Sicilia P, et al. Enterocytozoon bieneusi Infection after Hematopoietic Stem Cell Transplant in Child, Argentina. Emerg Infect Dis. 2024;30(3):613-616. https://doi.org/10.3201/eid3003.231580
AMA Mena C, Garófalo M, Perazzo J, et al. Enterocytozoon bieneusi Infection after Hematopoietic Stem Cell Transplant in Child, Argentina. Emerging Infectious Diseases. 2024;30(3):613-616. doi:10.3201/eid3003.231580.
APA Mena, C., Garófalo, M., Perazzo, J., Epelbaum, C., Castro, G., Sicilia, P....Chiapello, L. S. (2024). Enterocytozoon bieneusi Infection after Hematopoietic Stem Cell Transplant in Child, Argentina. Emerging Infectious Diseases, 30(3), 613-616. https://doi.org/10.3201/eid3003.231580.

Subdural Empyema from Streptococcus suis Infection, South Korea [PDF - 587 KB - 4 pages]
S. Choi et al.

In Jeju Island, South Korea, a patient who consumed raw pig products had subdural empyema, which led to meningitis, sepsis, and status epilepticus. We identified Streptococcus suis from blood and the subdural empyema. This case illustrates the importance of considering dietary habits in similar clinical assessments to prevent misdiagnosis.

EID Choi S, Park T, Lee H, Kim T, Joo J, Huh J, et al. Subdural Empyema from Streptococcus suis Infection, South Korea. Emerg Infect Dis. 2024;30(3):616-619. https://doi.org/10.3201/eid3003.231018
AMA Choi S, Park T, Lee H, et al. Subdural Empyema from Streptococcus suis Infection, South Korea. Emerging Infectious Diseases. 2024;30(3):616-619. doi:10.3201/eid3003.231018.
APA Choi, S., Park, T., Lee, H., Kim, T., Joo, J., Huh, J....Rhim, J. (2024). Subdural Empyema from Streptococcus suis Infection, South Korea. Emerging Infectious Diseases, 30(3), 616-619. https://doi.org/10.3201/eid3003.231018.

Incursion of Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus, Brazil, 2023 [PDF - 515 KB - 3 pages]
A. de Araújo et al.

We report 4 highly pathogenic avian influenza A(H5N1) clade 2.3.4.4.b viruses in samples collected during June 2023 from Royal terns and Cabot’s terns in Brazil. Phylodynamic analysis revealed viral movement from Peru to Brazil, indicating a concerning spread of this clade along the Atlantic Americas migratory bird flyway.

EID de Araújo A, Silva L, Cho A, Repenning M, Amgarten D, de Moraes A, et al. Incursion of Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus, Brazil, 2023. Emerg Infect Dis. 2024;30(3):619-621. https://doi.org/10.3201/eid3003.231157
AMA de Araújo A, Silva L, Cho A, et al. Incursion of Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus, Brazil, 2023. Emerging Infectious Diseases. 2024;30(3):619-621. doi:10.3201/eid3003.231157.
APA de Araújo, A., Silva, L., Cho, A., Repenning, M., Amgarten, D., de Moraes, A....Ferreira, H. (2024). Incursion of Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus, Brazil, 2023. Emerging Infectious Diseases, 30(3), 619-621. https://doi.org/10.3201/eid3003.231157.

Betacoronavirus Infection Outbreak, São Paulo, Brazil, Fall 2023 [PDF - 747 KB - 3 pages]
T. Chaves et al.

We report a human coronavirus OC43 infection outbreak in hospitalized patients and healthcare workers in São Paulo, Brazil, occurring after SARS-CoV-2 cases disappeared. Infection was associated with healthcare workers in 5 (29.4%) patients. Routine surveillance including a respiratory virus panel can improve coronavirus detection in both healthcare professionals and patients.

EID Chaves T, Perosa AH, Barbosa G, Ferreira DB, Bellei N. Betacoronavirus Infection Outbreak, São Paulo, Brazil, Fall 2023. Emerg Infect Dis. 2024;30(3):622-624. https://doi.org/10.3201/eid3003.230990
AMA Chaves T, Perosa AH, Barbosa G, et al. Betacoronavirus Infection Outbreak, São Paulo, Brazil, Fall 2023. Emerging Infectious Diseases. 2024;30(3):622-624. doi:10.3201/eid3003.230990.
APA Chaves, T., Perosa, A. H., Barbosa, G., Ferreira, D. B., & Bellei, N. (2024). Betacoronavirus Infection Outbreak, São Paulo, Brazil, Fall 2023. Emerging Infectious Diseases, 30(3), 622-624. https://doi.org/10.3201/eid3003.230990.
Another Dimension

The Last of Us and the Question of a Fungal Pandemic in Real Life [PDF - 239 KB - 4 pages]
G. Pappas and G. Vrioni

The television series The Last of Us imagines a postapocalyptic world ravaged by a fungal pandemic caused by a Cordyceps species. We evaluate whether a fungal pandemic is possible (and reasons behind its current improbability). We further discuss the series’ effect on public perception of fungi, fungal infections, and pandemic response.

EID Pappas G, Vrioni G. The Last of Us and the Question of a Fungal Pandemic in Real Life. Emerg Infect Dis. 2024;30(3):595-598. https://doi.org/10.3201/eid3003.230684
AMA Pappas G, Vrioni G. The Last of Us and the Question of a Fungal Pandemic in Real Life. Emerging Infectious Diseases. 2024;30(3):595-598. doi:10.3201/eid3003.230684.
APA Pappas, G., & Vrioni, G. (2024). The Last of Us and the Question of a Fungal Pandemic in Real Life. Emerging Infectious Diseases, 30(3), 595-598. https://doi.org/10.3201/eid3003.230684.
Books and Media

Larone’s Medically Important Fungi: A Guide to Identification, 7 Edition [PDF - 920 KB - 2 pages]
M. M. Azar
EID Azar MM. Larone’s Medically Important Fungi: A Guide to Identification, 7 Edition. Emerg Infect Dis. 2024;30(3):625-626. https://doi.org/10.3201/eid3003.231623
AMA Azar MM. Larone’s Medically Important Fungi: A Guide to Identification, 7 Edition. Emerging Infectious Diseases. 2024;30(3):625-626. doi:10.3201/eid3003.231623.
APA Azar, M. M. (2024). Larone’s Medically Important Fungi: A Guide to Identification, 7 Edition. Emerging Infectious Diseases, 30(3), 625-626. https://doi.org/10.3201/eid3003.231623.
About the Cover

Mental Health and Tuberculosis—Holding Our Breath in Isolation [PDF - 1.19 MB - 2 pages]
R. Fukunaga and P. K. Moonan
EID Fukunaga R, Moonan PK. Mental Health and Tuberculosis—Holding Our Breath in Isolation. Emerg Infect Dis. 2024;30(3):627-628. https://doi.org/10.3201/eid3003.ac3003
AMA Fukunaga R, Moonan PK. Mental Health and Tuberculosis—Holding Our Breath in Isolation. Emerging Infectious Diseases. 2024;30(3):627-628. doi:10.3201/eid3003.ac3003.
APA Fukunaga, R., & Moonan, P. K. (2024). Mental Health and Tuberculosis—Holding Our Breath in Isolation. Emerging Infectious Diseases, 30(3), 627-628. https://doi.org/10.3201/eid3003.ac3003.
Page created: February 15, 2024
Page updated: February 26, 2024
Page reviewed: February 26, 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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