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RESEARCH25. Taha TE, Kumwenda N, Kafulafula G, Makanani B, Nkhoma C,Chen S, et al. Intermittent intravaginal antibiotic treatment ofbacterial vaginosis in HIV-uninfected and infected women:a randomized clinical trial. PLoS Clin Trials. 2007;2:e10.http://dx.doi.org/10.1371/journal.pctr.002001026. Kumwenda NI, Hoover DR, Mofenson LM, Thigpen MC,Kafulafula G, Li Q, et al. Extended antiretroviral prophylaxisto reduce breast-milk HIV-1 transmission. N Engl J Med.2008;359:119–29. http://dx.doi.org/10.1056/NEJMoa080194127. Bendall R, Ellis V, Ijaz S, Ali R, Dalton H. A comparison of twocommercially available anti-HEV IgG kits and a re-evaluationof anti-HEV IgG seroprevalence data in developed countries.J Med Virol. 2010;82:799–805. http://dx.doi.org/10.1002/jmv.2165628. Naing L, Winn T, Rusli BN. Practical issues in calculating thesample size for prevalence studies. Archives of Orofacial Sciences.2006;1:9–14. 29. Malawi Demographic and Health Survey 2010:Final Report. National Statistics Office of Malawi (Zomba, Malawi)and MEASURE DHS/ICF Macro (Calverton, USA); 2011 [cited11/03/2014]. http://dhsprogram.com/pubs/<strong>pdf</strong>/FR247/FR247.<strong>pdf</strong>30. Kuniholm MH, Labrique AB, Nelson KE. Should HIV-infectedpatients with unexplained chronic liver enzyme elevations betested for hepatitis E Virus? Clin Infect Dis. 2010;50:1545–6.http://dx.doi.org/10.1086/652716Address for correspondence: Taha E. Taha, Johns Hopkins BloombergSchool of Public Health, Rm E7132A, 615 N Wolfe St, Baltimore, MD21205, USA; email: ttaha1@jhu.eduSearch past issues of EIDat wwwnc.cdc.gov/eid1182 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015
POLICY REVIEWChronic Q Fever Diagnosis—Consensus Guidelineversus Expert OpinionLinda M. Kampschreur, Marjolijn C.A. Wegdam-Blans, Peter C. Wever, Nicole H.M. Renders,Corine E. Delsing, Tom Sprong, Marjo E.E. van Kasteren, Henk Bijlmer, Daan Notermans,Jan Jelrik Oosterheert, Frans S. Stals, Marrigje H. Nabuurs-Franssen,Chantal P. Bleeker-Rovers, on behalf of the Dutch Q Fever Consensus Group 1Chronic Q fever, caused by Coxiella burnetii, has highmortality and morbidity rates if left untreated. Controversyabout the diagnosis of this complex disease has emergedrecently. We applied the guideline from the Dutch Q FeverConsensus Group and a set of diagnostic criteria proposedby Didier Raoult to all 284 chronic Q fever patientsincluded in the Dutch National Chronic Q Fever Databaseduring 2006–2012. Of the patients who had proven casesof chronic Q fever by the Dutch guideline, 46 (30.5%)would not have received a diagnosis by the alternative criteriadesigned by Raoult, and 14 (4.9%) would have beenconsidered to have possible chronic Q fever. Six patientswith proven chronic Q fever died of related causes. Untilresults from future studies are available, by which currentguidelines can be modified, we believe that the Dutch literature-basedconsensus guideline is more sensitive andeasier to use in clinical practice.Coxiella burnetii is the causative agent of Q fever, a zoonosisoccurring worldwide (1). Recently, a large epidemicoccurred in the Netherlands with >4,000 cases of acute Qfever notified from 2007 through 2010 (2,3). Chronic Q feverdevelops in an estimated 1%–5% of all infected humansand can become manifest even years after primary infection(1,4). Endocarditis and infection in aneurysms or vascularAuthor affiliations: Jeroen Bosch Hospital, ’s-Hertogenbosch,the Netherlands (L.M. Kampschreur, P.C. Wever, N.H.M. Renders);University Medical Center Utrecht, Utrecht, the Netherlands(L.M. Kampschreur, J.J. Oosterheert); Laboratory for Pathologyand Medical Microbiology, Veldhoven, the Netherlands(M.C.A. Wegdam-Blans); Radboud University Medical Center,Nijmegen, the Netherlands (C.E. Delsing, C.P. Bleeker-Rovers);Canisius-Wilhelmina Ziekenhuis, Nijmegen (T. Sprong);Canisius-Wilhelmina Ziekenhuis, Nijmegen (T. Sprong,M.H. Nabuurs-Franssen); St. Elisabeth Hospital, Tilburg,the Netherlands (M.E.E. van Kasteren); National Institute forPublic Health and the Environment, Bilthoven, the Netherlands(H. Bijlmer, D. Notermans); Atrium Medical Centre, Heerlen, theNetherlands (F.S. Stals)DOI: http://dx.doi.org/10.3201/eid2107.130955prostheses are the most common manifestations (1,5,6). Untreatedchronic Q fever has a poor prognosis, with a reportedmortality rate of up to 60% (1,7). Adequate antibiotic treatmentreduces the mortality rate for Q fever endocarditis to
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July 2015SynopsisOn the CoverMarian
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1240 Gastroenteritis OutbreaksCause
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SYNOPSISDisseminated Infections wit
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Disseminated Infections with Talaro
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Disseminated Infections with Talaro
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Macacine Herpesvirus 1 inLong-Taile
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Macacine Herpesvirus 1 in Macaques,
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Malaria among Young Infants, Africa
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RESEARCHFigure 3. Dynamics of 19-kD
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Transdermal Diagnosis of MalariaUsi
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RESEARCHFigure 2. A) Acoustic trace
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RESEARCHof malaria-infected mosquit
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Lack of Transmission amongClose Con
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RESEARCH(IFA) and microneutralizati
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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
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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
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Page 66 and 67: RESEARCHmeasure their current surve
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Page 78 and 79: RESEARCHpresence of Legionella spp.
Page 80 and 81: Seroprevalence for Hepatitis Eand O
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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
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Page 106 and 107: DISPATCHESFigure 2. Interaction of
Page 108 and 109: DISPATCHESSchmallenberg Virus Recur
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Page 112 and 113: DISPATCHESFigure 1. Histopathologic
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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
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Bufavirus in Wild Shrews and Nonhum
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Range Expansion for Rat Lungworm in
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Slow Clearance of Plasmodium falcip
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Slow Clearance of Plasmodium falcip
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Gastroenteritis Caused by Norovirus
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Ebola Virus Stability on Surfaces a
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Ebola Virus Stability on Surfaces a
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Outbreak of Ciprofloxacin-Resistant
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Outbreak of S. sonnei, South KoreaT
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Rapidly Expanding Range of Highly P
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Cluster of Ebola Virus Disease, Bon
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Cluster of Ebola Virus Disease, Lib
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ANOTHER DIMENSIONThe Past Is Never
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Measles Epidemic, Boston, Massachus
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LETTERSInfluenza A(H5N6)Virus Reass
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LETTERSsystem (8 kb-span paired-end
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LETTERS3. Van Hong N, Amambua-Ngwa
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LETTERSTable. Prevalence of Bartone
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LETTERSavian influenza A(H5N1) viru
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LETTERSprovinces and a total of 200
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LETTERS7. Manian FA. Bloodstream in
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LETTERSforward projections. N Engl
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LETTERS3. Guindon S, Gascuel OA. Si
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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
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