DISPATCHESnucleocapsid of >12% (>20% for both viruses), presence ofspecific host species, and existence of laboratory isolates.These properties indicate that MRTV and OKAV representdistinct arenavirus species.These 2 viruses were found in the same host specieslocated within a radius of 300 km. MRTV was found inonly 1 sample (of 266); OKAV was detected in samplesfrom 3 animals. Although more unlikely for OKAV thanfor MRTV, the possibility of a spillover infection to M. namaquensisfrom a still unknown reservoir host cannot beruled out for either virus.The Namaqua rock mouse’s habitat includes the treeand shrub savannahs of Namibia and most parts of southernAfrica, including Namibia, South Africa, Botswana, Zimbabwe,and parts of Mozambique (15). These locations implythe possible occurrence of MRTV or OKAV in largerregions of the continent. Cell culture isolates and genomicsequence data are the first prerequisites for evaluating thepublic health relevance of these new viruses. Our findingsextend the knowledge of geographic distribution and geneticdiversity of arenaviruses in Africa.AcknowledgmentsWe thank C. Chimimba for advice in small mammal systematics,P. Chimwamurombe for advice during preliminary screening forarenaviruses, and C. Priemer for technical support.Trapping in Namibia was carried out under research permit nos.1572/2011, 1666/2012 and 1794/2013, granted by Namibia’sMinistry of Environment and Tourism.This study was supported by Deutsche Forschungsgemeinschaft(grant KR1293/13-1) and by the Slovak Research andDevelopment Agency under the contract no. DO7RP-0008-09.Dr. Witkowski is a postdoctoral researcher at the Institute ofVirology of the Charité Medical School in Berlin, Germany. Hisresearch interests are viral emerging infectious diseases on theAfrican continent and their clinical impact and evolution.References1. Günther S, Lenz O. Lassa virus. Crit Rev Clin Lab Sci.2004;41:339–90. http://dx.doi.org/10.1080/104083604904974562. Briese T, Paweska JT, McMullan LK, Hutchison SK, Street C,Palacios G, et al. Genetic detection and characterization ofLujo virus, a new hemorrhagic fever-associated arenavirus fromsouthern Africa. PLoS Pathog. 2009;5:e1000455. http://dx.doi.org/10.1371/journal.ppat.10004553. Frame JD, Baldwin JM, Gocke DJ, Troupt AM. Lassa fever, anew virus disease of man from West Africa. Am J Trop Med Hyg.1970;19:670–6.4. N’Dilimabaka N, Berthet N, Rougeron V, Mangombi JB,Durand P, Maganga GD, et al. Evidence of lymphocyticchoriomeningitis virus (LCMV) in domestic mice in Gabon: riskof emergence of LCMV encephalitis in Central Africa. J Virol.2015;89:1456–60. http://dx.doi.org/10.1128/JVI.01009-145. Lecompte E, terMeulen J, Emonet S, Daffis S, Charrel RN. Geneticidentification of Kodoko virus, a novel arenavirus of the Africanpigmy mouse (Mus (Nannomys) minutoides) in West Africa. Virology.2007;364:178–83. http://dx.doi.org/10.1016/j.virol.2007.02.0086. Coulibaly-N’Golo D, Allali B, Kouassi SK, Fichet-Calvet E,Becker-Ziaja B, Rieger T, et al. Novel arenavirus sequences inHylomyscus sp. and Mus (Nannomys) setulosus from Côte d’Ivoire:implications for evolution of arenaviruses in Africa. PLoS ONE.2011;6:e20893. http://dx.doi.org/10.1371/journal.pone.00208937. Ishii A, Thomas Y, Moonga L, Nakamura I, Ohnuma A,Hang’ombe B, et al. Novel arenavirus, Zambia. Emerg Infect Dis.2011;17:1921–4. http://dx.doi.org/10.3201/eid1710.104528. Zapata JC, Salvato MS. Arenavirus variations due to host-specificadaptation. Viruses. 2013;5:241–78. http://dx.doi.org/10.3390/v50102419. Joubert JJ, van der Merve CA, Lourens JH, Lecatsas G,Siegrühn C. Serological markers of hepatitis B virus andcertain other viruses in the population of eastern Caprivi,Namibia. Trans R Soc Trop Med Hyg. 1991;85:101–3.http://dx.doi.org/10.1016/0035-9203(91)90176-Y10. Vieth S, Drosten C, Lenz O, Vincent M, Omilabu S, Hass M, et al.RT-PCR assay for detection of Lassa virus and related Old Worldarenaviruses targeting the L gene. Trans R Soc Trop Med Hyg.2007;101:1253–64. http://dx.doi.org/10.1016/j.trstmh.2005.03.01811. Palacios G, Quan P, Jabado OJ, Conlan S, Hirschberg DL, Liu Y,et al. Panmicrobial oligonucleotide array for diagnosis ofinfectious diseases. Emerg Infect Dis. 2007;13:73–81.http://dx.doi.org/10.3201/eid1301.06083712. Kearse M, Moir R, Wilson A, Stones-Havas S, Cheung M,Sturrock S, et al. Geneious Basic: an integrated and extendabledesktop software platform for the organization and analysis ofsequence data. Bioinformatics. 2012;28:1647–9. http://dx.doi.org/10.1093/bioinformatics/bts19913. Tamura K, Stecher G, Peterson D, Filipski A, Kumar S. MEGA6:Molecular Evolutionary Genetics Analysis <strong>version</strong> 6.0. Mol BiolEvol. 2013;30:2725–9. http://dx.doi.org/10.1093/molbev/mst19714. Index of viruses—arenaviridae. In: Büchen-Osmond C, editor.The Universal Virus Database, <strong>version</strong> 4. New York: ColumbiaUniversity, 2006 [cited 2014 Aug 11]. www.ncbi.nlm.nih.gov/ICTVdb/Ictv/fs_index.htm15. Coetzee N, Griffin M, Taylor PJ. Aethomys namaquensis. In:The International Union for Conservation of Nature Red List ofThreatened Species. Version 2014.1. 2014 [cited 2014 Aug 11].www.iucnredlist.orgAddress for correspondence: Peter T. Witkowski, Institute of Virology,Charité Medical School, Charitéplatz 1, 10117 Berlin, Germany; email:peter.witkowski@charite.de1216 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015
Readability of Ebola Informationon Websites of Public Health Agencies,United States, United Kingdom, Canada,Australia, and EuropeEnrique Castro-Sánchez,Elpiniki Spanoudakis, Alison H. HolmesPublic involvement in efforts to control the current Ebolavirus disease epidemic requires understandable information.We reviewed the readability of Ebola informationfrom public health agencies in non–Ebola-affected areas.A substantial proportion of citizens would have difficultyunderstanding existing information, which would potentiallyhinder effective health-seeking behaviors.The outbreak of Ebola virus disease (EVD) that originatedin Guinea in April 2014 has become the largestknown epidemic of this pathogen and was declared an internationalpublic health emergency (1). In addition, repatriationof health care workers and volunteers to Europeand the United States has resulted in human-to-humantransmission in western health care organizations (2), thusbringing Ebola to the fore of public attention in settings farremoved from local outbreak areas.Currently, because there is no antiviral treatment orvaccine, surveillance and strict observation of recommendedinfection prevention and control measures, aided bypublic awareness regarding symptoms and prompt healthcare–seeking behavior, are essential efforts to control Ebola.In Africa, low awareness has led to community misunderstandingsand unwillingness to cooperate with medicalteams (3). In non–EVD-affected countries, nonrigorousinformation has resulted in unfounded fear among healthcare workers and citizens, disrupting the activity of hospitalscaring for persons with EVD (4).For health messages to be followed effectively, theymust be tailored to the health literacy of the audience.Health literacy, which refers to “the cognitive and socialskills which determine the motivation and ability of individualsto gain access to, understand and use informationin ways which promote and maintain good health” (5), hasbeen associated with better self-care (6). However, a substantialproportion of citizens worldwide have insufficientor inadequate health literacy (7).Author affiliations: Imperial College London, London, UK; andNational Institute for Health Research, LondonDOI: http://dx.doi.org/10.3201/eid2107.141829Several factors, including readability of informationprovided (8), can help reduce health literacy deficits.Readability refers to “the determination of thereading comprehension level a person must have tounderstand written materials” (9). It is recommendedthat health information materials should be written ata level typically understandable by an 11-year-oldperson (10). Such recommendations for clarity andunderstandability might be more effective if one considersthat anxiety or panic attributed to a highly virulentinfection, such as Ebola, might hinder comprehension ofrelated information (11).We examined readability of EVD public informationavailable from selected public health agencies in non–EVD-affected countries. Countries that have EVD shouldexplore how well this information would serve to reducepanic and anxiety and perform as an effective source ofadvice for the public.The StudyCurrent information on Ebola aimed at the public wasdownloaded from various websites; a list is provided inonline Technical Appendix (http://wwwnc.cdc.gov/EID/article/21/7/14-1829-Techapp1.<strong>pdf</strong>). Information wasretrieved from the European Centre for Disease Control(Ebola factsheet for the general public); the US Centersfor Disease Prevention and Control (CDC; Questions andanswers on Ebola); Public Health England (PHE) in theUnited Kingdom (Ebola: public health questions and answers);and the government of Canada (Ebola virus disease)on September 1, 2014 and from the government ofAustralia (Ebolavirus disease outbreaks in West Africa:important information for travellers, patients and consumers)and the World Health Organization (WHO; Advicefor individuals and families. Ebola guidance package) onNovember 11, 2014.Any figures, such as maps or pictograms, were removed,and content was then formatted as plain text anduploaded to a free online tool (http://www.readabilityformulas.com/free-readability-formula-tests.php/)fromwhich different readability indicators were obtained(online Technical Appendix). The causes, symptoms,risks, treatment, prevention, and surveillance pages inthe Canadian website were individually opened andEmerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015 1217
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1240 Gastroenteritis OutbreaksCause
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BOOKS AND MEDIAin the port cities o
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ABOUT THE COVERNorth was not intere
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Earning CME CreditTo obtain credit,
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Emerging Infectious Diseases is a p