RESEARCH9. Centers for Disease Control and Prevention. Intrauterine West Nilevirus infection—New York, 2002. MMWR Morb Mortal WklyRep. 2002;51:1135–6.10. Centers for Disease Control and Prevention. Possible West Nilevirus transmission to an infant through breast-feeding—Michigan,2002. MMWR Morb Mortal Wkly Rep. 2002;51:877–8.11. Centers for Disease Control and Prevention. West Nile virus:statistics and maps [cited 2014 Aug 24]. http://www.cdc.gov/westnile/statsMaps/12. Centers for Disease Control and Prevention. Assessing capacityfor the surveillance, prevention, and control of West Nile virus—United States, 1999 and 2004. MMWR Morb Mortal Wkly Rep.2006;55:150–3.13. Centers for Disease Control and Prevention. West Nile virusand other arboviral diseases—United States, 2012. MMWRMorb Mortal Wkly Rep. 2013;62:513–7.14. Centers for Disease Control and Prevention. Locally acquireddengue—Key West, Florida, 2009–2010. MMWR Morb MortalWkly Rep. 2010;59:577–81.15. Ruiz-Moreno D, Vargas IS, Olson KE, Harrington LC. Modelingdynamic introduction of chikungunya virus in the United States.PLoS Negl Trop Dis. 2012;6:e1918.16. World Health Organization. Global alert and response.Chikungunya in the French part of the Caribbean isle of SaintMartin. 2013 Dec 10 [cited 2014 Aug 24]. http://www.who.int/csr/don/2013_12_10a/en/index.html17. Centers for Disease Control and Prevention. Chikungunya in theAmericas. Spread of the virus in the Americas. 2014 Apr 7 [cited2014 Aug 24]. http://www.cdc.gov/chikungunya/geo/americas.html18. Ebel GD. Update on Powassan virus: emergence of a NorthAmerican tick-borne flavivirus. Annu Rev Entomol. 2010;55:95–110. http://dx.doi.org/10.1146/annurev-ento-112408-08544619. Council of State and Territorial Epidemiologists. Assessment ofcapacity in 2012 for the surveillance, prevention and control ofWest Nile virus and other mosquito-borne virus infections in stateand large city/county health departments and how it compares to2004. February 2014 [cited 2014 Aug 24]. http://www.cste2.org/docs/VBR.<strong>pdf</strong>20. Centers for Disease Control and Prevention. West Nile virus in theUnited States: guidelines for surveillance, prevention, and control.4th revision. June 14, 2013 [cited 2014 Aug 24]. http://www.cdc.gov/westnile/resources/<strong>pdf</strong>s/wnvGuidelines.<strong>pdf</strong>21. Centers for Disease Control and Prevention. Epi Info. 2013 Apr[cited 2014 Aug 24]. https://wwwn.cdc.gov/epiinfo/user-guide/survey/introduction.html22. United States Geological Survey. Dengue fever (imported, locallyacquired)—human, 2013. 2014 Jan [cited 2014 Aug 24].http://diseasemaps.usgs.gov/del_us_human.htmlAddress for correspondence: James L. Hadler, Emerging InfectionsProgram, Yale School of Public Health, 1 Church St, 7th Fl, New Haven,CT 06510, USA; emails: hadler-epi@att.net or hadlerepi@gmail.comApril 2015: Emerging VirusesIncluding:• Reappearance of Chikungunya, Formerly Called Dengue, in the Americas• Hantavirus Pulmonary Syndrome, Southern Chile, 1995–2012• Animal-Associated Exposure to Rabies Virus among Travelers, 1997–2012• Evolution of Ebola Virus Disease from Exotic Infection to Global Health Priority,Liberia, Mid-2014• Population Structure and Antimicrobial Resistance of Invasive Serotype IV Group BStreptococcus, Toronto, Ontario, Canada• Norovirus Genotype Profiles Associated with Foodborne Transmission,1999–2012• Deaths Associated with Respiratory Syncytial and Influenza Viruses among Persons>5 Years of Age in HIV-Prevalent Area, South Africa• Sequence Variability and Geographic Distribution of Lassa Virus, Sierra Leone• Influenza A(H7N9) Virus Transmission between Finches and Poultry• Highly Pathogenic Avian Influenza A(H5N1) Virus Infection among Workers at LiveBird Markets, Bangladesh, 2009–2010• Increased Risk for Group B Streptococcus Sepsis in Young Infants Exposed to HIV,Soweto, South Africa, 2004–2008http://wwwnc.cdc.gov/eid/articles/issue/21/4/table-of-contents1166 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015
Results from theNational Legionella OutbreakDetection Program,the Netherlands, 2002–2012Jeroen W. Den Boer, Sjoerd M. Euser, Petra Brandsema, Linda Reijnen, Jacob P. BruinIn 2002, the National Legionella Outbreak Detection Programwas implemented in the Netherlands to detect andeliminate potential sources of organisms that cause Legionnaires’disease (LD). During 2002–2012, a total of 1,991patients with LD were reported, and 1,484 source investigationswere performed. Of those sources investigated, 24.7%were positive for Legionella spp. For 266 patients with LD,105 cluster locations were identified. A genotype match wasmade between a strain detected in 41 patients and a strainfrom a source location. Despite the systematic approachused by the program, most sources of LD infections during2002–2012 remained undiscovered. Explorative studiesare needed to identify yet undiscovered reservoirs andtransmission routes for Legionella bacteria, and improvedlaboratory techniques are needed to detect Legionella spp.in clinical samples with a high background of microbial florasuch as soil.Legionnaires’ disease (LD) is an acute pneumonia characterizedby clinical symptoms and signs (e.g., cough,fever, lung infiltration observed on a chest radiograph) similarto those of pneumonias resulting from other pathogens.LD is caused by infection with Legionella spp. bacteria,which are most often transmitted to persons through inhalationof bacteria disseminated into the air as an aerosol fromnatural or man-made sources of water (1). The incubationperiod is 2–14 days. LD is thought to account for 2%–20%of all community-acquired pneumonias (2) and is fatal in≈6%–11% of cases (3,4).After a large outbreak of LD at a flower show inBovenkarspel, the Netherlands, in 1999 (5), preventionand control of Legionella spp. infections became a nationalconcern in the Netherlands, and legislation to prevent Legionellaspp. in drinking water systems was introduced (6,7).This legislation obligated owners of aerosol-producing devices(e.g., shower heads and whirlpools), if third partiesAuthor affiliations: Regional Public Health Laboratory Kennemerland,Haarlem, the Netherlands (J.W. Den Boer, S.M. Euser, L. Reijnen,J.P. Bruin); National Institute for Public Health and the Environment,Bilthoven, the Netherlands (P. Brandsema)DOI: http://dx.doi.org/10.3201/eid2107.141130may be exposed to them, to conduct a risk analysis, developa control plan, keep logs of control measures, and performregular sampling for Legionella spp. contamination. In addition,in 2002, a National Legionella Outbreak DetectionProgram (NLODP) was implemented (8) on the basis of areport that LD outbreaks are often preceded and followedby small clusters of solitary cases (9). The aims of NLODPare early detection of small clusters of cases, identificationof sources of infection, and implementation of early controlmeasures to prevent additional LD cases or an outbreak.For evaluation of transmission pathways, infection sourcesare sampled, and genotypes of Legionella strains found inthese samples are compared with those of clinical isolate(s)from the patient(s) associated with that source. To evaluatethe findings of the NLODP during 2002–2012, we analyzeddata to determine whether extensive investigation effortscould detect Legionella spp. in collected samples and conclusivelyidentify environmental sources.MethodsPatientsLD has been notifiable in the Netherlands since 1987. Acase of LD is defined as laboratory-confirmed infection ina person having symptoms compatible with pneumonia orradiologic signs of infiltration. Laboratory evidence maybe >1 of the following: isolation of Legionella spp. fromrespiratory secretions or lung tissue, detection of L. pneumophilaantigen in urine, serocon<strong>version</strong> or a >4-fold risein antibody titers to L. pneumophila in paired acute- andconvalescent-phase serum samples, a high antibody titer toL. pneumophila in a single serum sample, and direct fluorescentantibody staining of the organism or detection ofLegionella DNA by PCR in respiratory secretions or lungtissue. In the Netherlands, microbiologic laboratories involvedin the diagnosis and treatment of patients with pneumoniaare requested to send available clinical isolates ofLegionella spp. to the Legionella Source Identification Unit(LSIU), a part of the NLODP. LD cases in persons who hadbeen outside the country for >5 of 9 days before disease onsetwere defined as nondomestic cases and excluded fromEmerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015 1167
- Page 3 and 4:
July 2015SynopsisOn the CoverMarian
- Page 5 and 6:
1240 Gastroenteritis OutbreaksCause
- Page 7 and 8:
SYNOPSISDisseminated Infections wit
- Page 9 and 10:
Disseminated Infections with Talaro
- Page 11 and 12:
Disseminated Infections with Talaro
- Page 13 and 14:
Macacine Herpesvirus 1 inLong-Taile
- Page 15 and 16:
Macacine Herpesvirus 1 in Macaques,
- Page 17 and 18:
Macacine Herpesvirus 1 in Macaques,
- Page 19:
Macacine Herpesvirus 1 in Macaques,
- Page 23: Malaria among Young Infants, Africa
- Page 26 and 27: RESEARCHFigure 3. Dynamics of 19-kD
- Page 28 and 29: Transdermal Diagnosis of MalariaUsi
- Page 30 and 31: RESEARCHFigure 2. A) Acoustic trace
- Page 32 and 33: RESEARCHof malaria-infected mosquit
- Page 34 and 35: Lack of Transmission amongClose Con
- Page 36 and 37: RESEARCH(IFA) and microneutralizati
- Page 38 and 39: RESEARCHoropharyngeal, and serum sa
- Page 40 and 41: RESEARCH6. Assiri A, McGeer A, Perl
- Page 42 and 43: RESEARCHadvanced genomic sequencing
- Page 44 and 45: RESEARCHTable 2. Next-generation se
- Page 46 and 47: RESEARCHTable 3. Mutation analysis
- Page 48 and 49: RESEARCHReferences1. Baize S, Panne
- Page 50 and 51: Parechovirus Genotype 3 Outbreakamo
- Page 52 and 53: RESEARCHFigure 1. Venn diagramshowi
- Page 54 and 55: RESEARCHTable 2. HPeV testing of sp
- Page 56 and 57: RESEARCHFigure 5. Distribution of h
- Page 58 and 59: RESEARCHReferences1. Selvarangan R,
- Page 60 and 61: RESEARCHthe left lobe was sampled b
- Page 62 and 63: RESEARCHTable 2. Middle East respir
- Page 64 and 65: RESEARCHseroprevalence in domestic
- Page 66 and 67: RESEARCHmeasure their current surve
- Page 68 and 69: RESEARCHTable 2. States with labora
- Page 70 and 71: RESEARCHFigure 2. Comparison of sur
- Page 74 and 75: RESEARCHthe analyses. Cases in pers
- Page 76 and 77: RESEARCHTable 3. Sampling results (
- Page 78 and 79: RESEARCHpresence of Legionella spp.
- Page 80 and 81: Seroprevalence for Hepatitis Eand O
- Page 82 and 83: RESEARCHTable 1. Description of stu
- Page 84 and 85: RESEARCHTable 3. Crude and adjusted
- Page 86 and 87: RESEARCHrates by gender or HIV stat
- Page 88 and 89: RESEARCH25. Taha TE, Kumwenda N, Ka
- Page 90 and 91: POLICY REVIEWDutch Consensus Guidel
- Page 92 and 93: POLICY REVIEWTable 3. Comparison of
- Page 94 and 95: POLICY REVIEW6. Botelho-Nevers E, F
- Page 96 and 97: DISPATCHESFigure 1. Phylogenetic tr
- Page 98 and 99: DISPATCHESSevere Pediatric Adenovir
- Page 100 and 101: DISPATCHESTable 1. Demographics and
- Page 102 and 103: DISPATCHES13. Kim YJ, Hong JY, Lee
- Page 104 and 105: DISPATCHESTable. Alignment of resid
- Page 106 and 107: DISPATCHESFigure 2. Interaction of
- Page 108 and 109: DISPATCHESSchmallenberg Virus Recur
- Page 110 and 111: DISPATCHESFigure 2. Detection of Sc
- Page 112 and 113: DISPATCHESFigure 1. Histopathologic
- Page 114: DISPATCHESFigure 2. Detection of fo
- Page 117 and 118: Influenza Virus Strains in the Amer
- Page 119 and 120: Novel Arenavirus Isolates from Nama
- Page 121 and 122: Novel Arenaviruses, Southern Africa
- Page 123 and 124:
Readability of Ebola Informationon
- Page 125 and 126:
Readability of Ebola Information on
- Page 127 and 128:
Patients under investigation for ME
- Page 129 and 130:
Patients under investigation for ME
- Page 131 and 132:
Wildlife Reservoir for Hepatitis E
- Page 133 and 134:
Asymptomatic Malaria and Other Infe
- Page 135 and 136:
Asymptomatic Malaria in Children fr
- Page 137 and 138:
Bufavirus in Wild Shrews and Nonhum
- Page 139 and 140:
Bufavirus in Wild Shrews and Nonhum
- Page 141 and 142:
Range Expansion for Rat Lungworm in
- Page 143 and 144:
Slow Clearance of Plasmodium falcip
- Page 145 and 146:
Slow Clearance of Plasmodium falcip
- Page 147 and 148:
Gastroenteritis Caused by Norovirus
- Page 149 and 150:
Ebola Virus Stability on Surfaces a
- Page 151 and 152:
Ebola Virus Stability on Surfaces a
- Page 153 and 154:
Outbreak of Ciprofloxacin-Resistant
- Page 155 and 156:
Outbreak of S. sonnei, South KoreaT
- Page 157 and 158:
Rapidly Expanding Range of Highly P
- Page 159 and 160:
Cluster of Ebola Virus Disease, Bon
- Page 161 and 162:
Cluster of Ebola Virus Disease, Lib
- Page 163 and 164:
ANOTHER DIMENSIONThe Past Is Never
- Page 165 and 166:
Measles Epidemic, Boston, Massachus
- Page 167 and 168:
LETTERSInfluenza A(H5N6)Virus Reass
- Page 169 and 170:
LETTERSsystem (8 kb-span paired-end
- Page 171 and 172:
LETTERS3. Van Hong N, Amambua-Ngwa
- Page 173 and 174:
LETTERSTable. Prevalence of Bartone
- Page 175 and 176:
LETTERSavian influenza A(H5N1) viru
- Page 177 and 178:
LETTERSprovinces and a total of 200
- Page 179 and 180:
LETTERS7. Manian FA. Bloodstream in
- Page 181 and 182:
LETTERSforward projections. N Engl
- Page 183 and 184:
LETTERS3. Guindon S, Gascuel OA. Si
- Page 185 and 186:
BOOKS AND MEDIAin the port cities o
- Page 187 and 188:
ABOUT THE COVERNorth was not intere
- Page 189 and 190:
Earning CME CreditTo obtain credit,
- Page 191:
Emerging Infectious Diseases is a p