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Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Issues Available

Volume 29, Number 3—March 2023

  • Multicenter Retrospective Study of Vascular Infections and Endocarditis Caused by Campylobacter spp., France
    C. Tinévez et al.

    The incidence of campylobacteriosis has substantially increased over the past decade, notably in France. Secondary localizations complicating invasive infections are poorly described. We aimed to describe vascular infection or endocarditis caused by Campylobacter spp. We included 57 patients from a nationwide 5-year retrospective study on Campylobacter spp. bacteremia conducted in France; 44 patients had vascular infections, 12 had endocarditis, and 1 had both conditions. Campylobacter fetus was the most frequently involved species (83%). Antibiotic treatment involved a β-lactam monotherapy (54%) or was combined with a fluoroquinolone or an aminoglycoside (44%). The mortality rate was 25%. Relapse occurred in 8% of cases and was associated with delayed initiation of an efficient antimicrobial therapy after the first symptoms, diabetes, and coexistence of an osteoarticular location. Cardiovascular Campylobacter spp. infections are associated with a high mortality rate. Systematically searching for those localizations in cases of C. fetus bacteremia may be warranted.

  • Yellow Fever Vaccine–Associated Viscerotropic Disease among Siblings, Sao Paulo, Brazil
    E. Fernandes et al.
  • Bartonella spp. Infections Identified by Molecular Methods, USA
    D. W. McCormick et al.
  • Risk for Prison-to-Community Tuberculosis Transmission, Thailand, 2017–2020
    R. Miyahara et al.

    To determine contributions of previously incarcerated persons to tuberculosis (TB) transmission in the community, we performed a healthcare facility–based cohort study of TB patients in Thailand during 2017–2020. We used whole-genome sequencing of Mycobacterium tuberculosis isolates from patients to identify genotypic clusters and assess the association between previous incarceration and TB transmission in the community. We identified 4 large genotype clusters (>10 TB patients/cluster); 28% (14/50) of the patients in those clusters were formerly incarcerated. Formerly incarcerated TB patients were more likely than nonincarcerated patients to be included in large clusters. TB patients within the large genotype clusters were geographically dispersed throughout Chiang Rai Province. Community TB transmission in the community was associated with the presence of formerly incarcerated individuals in Thailand. To reduce the risk for prison-to-community transmission, we recommend TB screening at the time of entry and exit from prisons and follow-up screening in the community.

  • Prevalence of Mycobacterium tuberculosis Complex among Wild Rhesus Macaques and 2 Subspecies of Long-Tailed Macaques, Thailand, 2018–2022
    S. Meesawat et al.

    We identified tuberculosis in 1,836 macaques from 6 wild rhesus (Macaca mulatta), 23 common long-tailed (M. fascicularis fascicularis), and 6 Burmese long-tailed (M. fascicularis aurea) macaque populations in Thailand. We captured, anesthetized, and collected throat, buccal, and rectal swab specimens from the macaques. We screened swabs for Mycobacterium tuberculosis complex (MTBC) using insertion sequence 6110–specific nested PCR. We found higher MTBC prevalence at both population and individual levels among M. mulatta than M. fascicularis fascicularis macaques; all 3 M. fascicularis aurea macaque populations were positive for tuberculosis. We found that throat swab specimens provided the best sample medium for detecting MTBC. Our results showed no difference in MTBC prevalence between male and female animals, but a higher percentage of adults were infected than subadults and juveniles. Although we detected no association between frequency of human–macaque interaction and MTBC prevalence, bidirectional zoonotic transmission should be considered a possible public health concern.

  • Postacute Sequelae of SARS-CoV-2 in University Setting
    M. Landry et al.

    Postacute sequelae of SARS-CoV-2 infection, commonly known as long COVID, is estimated to affect 10% to 80% of COVID-19 survivors. We examined the prevalence and predictors of long COVID from a sample of 1,338 COVID-19 cases among university members in Washington, DC, USA, during July 2021‒March 2022. Cases were followed up after 30 days of the initial positive result with confidential electronic surveys including questions about long COVID. The prevalence of long COVID was 36%. Long COVID was more prevalent among those who had underlying conditions, who were not fully vaccinated, who were female, who were former/current smokers, who experienced acute COVID-19 symptoms, who reported higher symptom counts, who sought medical care, or who received antibody treatment. Understanding long COVID among university members is imperative to support persons who have ongoing symptoms and to strengthen existing services or make referrals to other services, such as mental health, exercise programs, or long-term health studies.

  • Increase in Colorado Tick Fever Virus Disease Cases and Effect of COVID-19 Pandemic on Behaviors and Testing Practices, Montana, 2020
    R. A. Soto et al.

    In 2020, Montana, USA, reported a large increase in Colorado tick fever (CTF) cases. To investigate potential causes of the increase, we conducted a case–control study of Montana residents who tested positive or negative for CTF during 2020, assessed healthcare providers’ CTF awareness and testing practices, and reviewed CTF testing methods. Case-patients reported more time recreating outdoors on weekends, and all reported finding a tick on themselves before illness. No consistent changes were identified in provider practices. Previously, only CTF serologic testing was used in Montana. In 2020, because of SARS-CoV-2 testing needs, the state laboratory sent specimens for CTF testing to the Centers for Disease Control and Prevention, where more sensitive molecular methods are used. This change in testing probably increased the number of CTF cases detected. Molecular testing is optimal for CTF diagnosis during acute illness. Tick bite prevention measures should continue to be advised for persons doing outdoor activities.

  • Comparative Effectiveness of COVID-19 Vaccines in Preventing Infections and Disease Progression from SARS-CoV-2 Omicron BA.5 and BA.2, Portugal
    I. Kislaya et al.

    We estimated comparative primary and booster vaccine effectiveness (VE) of SARS-CoV-2 Omicron BA.5 and BA.2 lineages against infection and disease progression. During April–June 2022, we implemented a case–case and cohort study and classified lineages using whole-genome sequencing or spike gene target failure. For the case–case study, we estimated the adjusted odds ratios (aORs) of vaccination using a logistic regression. For the cohort study, we estimated VE against disease progression using a penalized logistic regression. We observed no reduced VE for primary (aOR 1.07 [95% CI 0.93–1.23]) or booster (aOR 0.96 [95% CI 0.84–1.09]) vaccination against BA.5 infection. Among BA.5 case-patients, booster VE against progression to hospitalization was lower than that among BA.2 case-patients (VE 77% [95% CI 49%–90%] vs. VE 93% [95% CI 86%–97%]). Although booster vaccination is less effective against BA.5 than against BA.2, it offers substantial protection against progression from BA.5 infection to severe disease.

  • COVID-19 Test Allocation Strategy to Mitigate SARS-CoV-2 Infections across School Districts
    R. Pasco et al.

    In response to COVID-19, schools across the United States closed in early 2020; many did not fully reopen until late 2021. Although regular testing of asymptomatic students, teachers, and staff can reduce transmission risks, few school systems consistently used proactive testing to safeguard return to classrooms. Socioeconomically diverse public school districts might vary testing levels across campuses to ensure fair, effective use of limited resources. We describe a test allocation approach to reduce overall infections and disparities across school districts. Using a model of SARS-CoV-2 transmission in schools fit to data from a large metropolitan school district in Texas, we reduced incidence between the highest and lowest risk schools from a 5.6-fold difference under proportional test allocation to 1.8-fold difference under our optimized test allocation. This approach provides a roadmap to help school districts deploy proactive testing and mitigate risks of future SARS-CoV-2 variants and other pathogen threats.

  • Clonal Dissemination of Antifungal-Resistant Candida haemulonii, China
    X. Chen et al.

    Candida haemulonii, a relative of C. auris, frequently shows antifungal resistance and is transmissible. However, molecular tools for genotyping and investigating outbreaks are not yet established. We performed genome-based population analysis on 94 C. haemulonii strains, including 58 isolates from China and 36 other published strains. Phylogenetic analysis revealed that C. haemulonii can be divided into 4 clades. Clade 1 comprised strains from China and other global strains; clades 2–4 contained only isolates from China, were more recently evolved, and showed higher antifungal resistance. Four regional epidemic clusters (A, B, C, and D) were identified in China, each comprising ≥5 cases (largest intracluster pairwise single-nucleotide polymorphism differences <50 bp). Cluster A was identified in 2 hospitals located in the same city, suggesting potential intracity transmissions. Cluster D was resistant to 3 classes of antifungals. The emergence of more resistant phylogenetic clades and regional dissemination of antifungal-resistant C. haemulonii warrants further monitoring.

  • Using Discarded Facial Tissues to Monitor and Diagnose Viral Respiratory Infections
    G. Lagathu et al.

    Molecular biology amplification enables sensitive detection of most respiratory viruses through nasopharyngeal swabbing. We developed an innovative approach to detect viral genomes on used facial tissues. In 2 communities of children, used tissues were collected once weekly for 1 year. Pooled analysis of tissues enabled detection of successive virus circulation in 4 age groups over time and forecasted by several weeks the circulation of influenza in the general population. At the individual level, in a proof-of-concept study of 30 volunteers with influenza-like signs/symptoms, we identified common respiratory viruses. The signals for SARS-CoV-2 obtained in parallel from 15 facial tissues and swab samples were similar and often higher for the tissues (11/15). Individual analysis of tissues offers a noninvasive, sensitive, and affordable alternative to self-sampling without a medical care requirement. Pooled analyses may be used to detect virus spread in specific communities, predict seasonal epidemics, and alert the population to viral infections.

  • Clonal Expansion of Multidrug-Resistant Streptococcus dysgalactiae subsp. equisimilis Causing Bacteremia, Japan, 2005–2021
    K. Shinohara et al.
  • Associations of Anaplasma phagocytophilum Bacteria Variants in Ixodes scapularis Ticks and Humans, New York, USA
    M. Prusinski et al.
  • Risk Factors for Reinfection with SARS-CoV-2 Omicron Variant among Previously Infected Frontline Workers
    K. D. Ellingson et al.

    In a cohort of essential workers in the United States previously infected with SARS-CoV-2, risk factors for reinfection included being unvaccinated, infrequent mask use, time since first infection, and being non-Hispanic Black. Protecting workers from reinfection requires a multipronged approach including up-to-date vaccination, mask use as recommended, and reduction in underlying health disparities.

  • Reemergence of Lymphocytic Choriomeningitis Mammarenavirus, Germany
    C. Mehl et al.
  • SARS-CoV-2 Incubation Period during the Omicron BA.5–Dominant Period in Japan
    T. Ogata and H. Tanaka

    The mean virus incubation period during the SARS-CoV-2 Omicron BA.5–dominant period in Japan was 2.6 (95% CI 2.5–2.8) days, which was less than during the Delta-dominant period. Incubation period correlated with shared meals and adult infectors. A shorter incubation suggests a shorter quarantine period for BA.5 than for other variants.

  • Emergomyces pasteurianus in Patient from Liberia and Review of the Literature
    J. Pierce et al.
  • Mycobacterium leprae in Armadillo Tissues from Museum Collections, United States
    D. Romero-Alvarez et al.
  • Seroprevalence of Specific SARS-CoV-2 Antibodies during Omicron BA.5 Wave, Portugal, April–June 2022
    I. Kislaya et al.

    After the rapid spreadof SARS-CoV-2 BA.5 Omicron lineage in Portugal, we developed a seroepidemiologic survey based on a sample of 3,825 residents. Results indicated that from April 27 through June 8, 2022, the estimated seroprevalence of SARS-CoV-2 nucleocapsid or spike IgG was 95.8%, which indicates a high level of protection.

  • Burkholderia thailandensis Isolated from the Environment, United States
    C. M. Hall et al.
  • New Detection of Locally Acquired Japanese Encephalitis Virus using Clinical Metagenomics, New South Wales, Australia
    J. Maamary et al.
  • Correlation of High Seawater Temperature with Vibrio and Shewanella Infections, Denmark, 2010–2018
    Y. G. Hounmanou et al.
  • Tuberculosis Preventive Therapy among Persons Living with HIV, Uganda, 2016–2022
    D. Lukoye et al.
  • Nosocomial Infections with Severe Fever with Thrombocytopenia Syndrome Virus in Companion Animals, Japan, 2022
    H. Mekata et al.
  • Extended Viral Shedding of MERS-CoV Clade B Virus in Llamas Compared with African Clade C Strain
    J. Rodon et al.

    Middle East respiratory syndrome coronavirus (MERS-CoV) clade B viruses are found in camelids and humans in the Middle East, but clade C viruses are not. We provide experimental evidence for extended shedding of MERS-CoV clade B viruses in llamas, which might explain why they outcompete clade C strains in the Arabian Peninsula.

Research Letters
  • Tick-Borne Encephalitis in Pregnant Woman and Long-Term Sequelae
    A. Velay et al.
  • Babesia microti Causing Intravascular Hemolysis in Immunocompetent Child, China
    J. Yao et al.
  • Possible Mpox Protection from Smallpox Vaccine–Generated Antibodies among Older Adults
    I. Sanz-Muñoz et al.

    Smallpox vaccination may confer cross-protection to mpox. We evaluated vaccinia virus antibodies in 162 persons ≥50 years of age in Spain; 68.5% had detectable antibodies. Highest coverage (78%) was among persons 71–80 years of age. Low antibody levels in 31.5% of this population indicates that addressing their vaccination should be a priority.

  • Sustained Mpox Proctitis with Primary Syphilis and HIV Seroconversion, Australia
    R. M. Burdon et al.

    A 26-year-old man in Australia who has sex with men had severe perianal ulceration, proctitis, and skin lesions develop. Testing revealed primary syphilis, mpox, and primary HIV infection. Recent publications have documented severe mpox associated with HIV infection. Disruption of mucosal integrity by mpox lesions could enable HIV transmission and vice versa.

  • New Postmortem Perspective on Emerging SARS-CoV-2 Variants of Concern, Germany
    F. Heinrich et al.
  • Inquilinus limosus Bacteremia in Lung Transplant Recipient, France
    E. Farfour et al.
  • Intrahost Monkeypox Virus Genome Variation in Patient with Early Infection, Finland, 2022
    H. Vauhkonen et al.

    Monkeypox virus was imported into Finland during late May–early June 2022. Intrahost viral genome variation in a sample from 1 patient comprised a major variant with 3 lineage B.1.3–specific mutations and a minor variant with ancestral B.1 nucleotides. Results suggest either ongoing APOBEC3 enzyme–mediated evolution or co-infection.

  • SARS-CoV-2 Spillback to Wild Coatis in Sylvatic–Urban Hotspot, Brazil
    A. Stoffella-Dutra et al.
  • Emergence of Mycobacterium orygis–Associated TB in Wild Ruminants, India
    M. Sharma et al.
  • SARS-CoV-2 Infection in a Hippopotamus, Hanoi, Vietnam
    V. Bui et al.
  • Recurrent Cellulitis Revealing Helicobacter cinaedi in a Patient on Ibrutinib Therapy, France
    A. Roupie et al.
  • Genomic Analysis of Early Monkeypox Virus Outbreak Strains, Washington, United States
    P. Roychoudhury et al.

    We conducted a genomic analysis of monkeypox virus sequences collected early in the 2022 outbreak, during July–August , in Washington, USA. Using 109 viral genomes, we found low overall genetic diversity, multiple introductions into the state, ongoing community transmission, and potential for co-infections by multiple strains.

Books and Media
  • Phantom Plague: How Tuberculosis Shaped History
    H. M. Blumberg
Online Report
  • Interventions to Reduce Risk of Pathogen Spillover and Subsequent Early Disease Spread to Prevent Outbreaks, Epidemics, and Pandemics
    N. M. Vora et al.
Conference Summary
  • The 100 Days Mission—2022 Global Pandemic Preparedness Summit
    D. Gouglas et al.


Volume 29, Number 4—April 2023

  • Challenges in Forecasting Antimicrobial Resistance
    S. Pei et al.
  • Pediatric Invasive Meningococcal Disease in Auckland, New Zealand, 2004–2020
    C. Burton et al.
  • Nocardia pseudobrasiliensis Co-infection in SARS-CoV-2 Patients
    D. Stamos et al.
  • Monitoring Temporal Changes in SARS-CoV-2 Spike Antibody Levels and Variant-Specific Risk for Infection, Dominican Republic, March 2021–August 2022
    E. J. Nilles et al.
  • Use of High-Resolution Geospatial and Genomic Data to Characterize Recent Tuberculosis Transmission, Botswana
    C. R. Baker et al.
  • Detection of Adeno-Associated Virus 2 and Human Adenovirus Type 41 in Wastewater Coincident to Pediatric Cases of Severe Acute Hepatitis of Unknown Etiology
    N. A. Martin et al.
  • Conditions that Facilitated Extensive Spread of SARS-CoV-2 Delta Variant among Vaccinated Persons during 7-Day River Cruise
    T. Veenstra et al.
  • Model Map of Global Bushmeat Activities to Improve Zoonotic Spillover Surveillance
    S. Jagadesh et al.
  • Experimental Infection and Transmission of SARS-CoV-2 Delta and Omicron Variants among Beagle Dogs
    K. Lyoo et al.
  • Monkeypox Virus Infection in 2 Female Travelers Returning to Vietnam from Dubai, United Arab Emirates, 2022
    N. Dung et al.

    Mpox was diagnosed in 2 women returning to Vietnam from the United Arab Emirates. The monkeypox viruses belonged to an emerging sublineage, A.2.1, distinct from B.1, which is responsible for the ongoing multicountry outbreak. Women could contribute to mpox transmission, and enhanced genomic surveillance is needed to clarify pathogen evolution.

  • Serial Intervals and Incubation Periods of SARS-CoV-2 Omicron and Delta Variants, Singapore
    K. Zeng et al.
  • Reported and Sampling Data for SARS-CoV-2, Verona, Italy, May 2020‒2022
    Z. Bisoffi et al.
  • Serial Interval and Incubation Period Estimates of Monkeypox Virus Infection in 12 Jurisdictions, United States, May–August 2022
    Z. J. Madewell et al.
  • Emergence and Persistent Dominance of Omicron BA.2.3.7 Variant, Taiwan
    P. Shao et al.
  • Ocular Trematodiasis in Children, Sri Lanka
    C. H. Mallawarachchi et al.
  • Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in New England Seals, USA
    W. Puryear et al.
  • Yezo Virus Infection in Tick-Bitten Patient and Ticks, Northeastern China
    X. Lv et al.
Research Letters
  • Mpox in Young Woman with No Epidemiologic Risk Factors, Massachusetts, USA
    M. J. Siedner et al.

    We describe a case of mpox characterized by a circularly distributed facial rash but no identified risk factors. Fomite transmission of monkeypox virus from contaminated linen at a massage spa was suspected. Clinicians should consider mpox in patients with consistent clinical syndromes, even in the absence of epidemiologic risk factors.

  • Fatal Infection of Highly Pathogenic Avian Influenza A (H5N1) Virus in Phocoena phocoena Harbor Porpoise
    E. Thorsson et al.
  • Preventing Thelazia callipaeda Reinfection among Humans
    M. Trenkić et al.
  • Powassan Virus Infection Detected by Metagenomic Next-Generation Sequencing, Ohio, USA
    M. Farrington et al.
  • Human Metapneumovirus Infections during COVID-19 Pandemic, Spain
    M. L. García-García et al.
  • Experimental Infection of North American Deer Mice with Clade 1 and 2 Monkeypox Virus Isolates
    Y. Deschambault et al.
  • Genomic Characterization of Respiratory Syncytial Virus during 2022–2023 Outbreak, Washington, USA
    S. Goya et al.
Online Report
  • Implications for Pandemic Preparedness Priorities of Global Veterinary Diagnostic Laboratory Equipment Management and Sustainability
    J. N. Lasley et al.


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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