Early Release

Synopses

• Pasteurella Infections in South Korea and Systematic Review and Meta-analysis of Pasteurella Bacteremia
  S. Jeong et al.
• Campylobacteriosis Outbreak Linked to Municipal Water, Nebraska, USA, 2021
  L. Jansen et al. View Abstract

  In September 2021, eight campylobacteriosis cases were identified in a town in Nebraska, USA. We assessed potential exposures for a case–control analysis. We conducted whole-genome sequencing on Campylobacter isolates from patients’ stool specimens. We collected large-volume dead-end ultrafiltration water samples for Campylobacter and microbial source tracking testing at the Centers for Disease Control and Prevention. We identified 64 cases in 2 waves of illnesses. Untreated municipal tap water consumption was strongly associated with illness (wave 1 odds ratio 15.36; wave 2 odds ratio 16.11). Whole-genome sequencing of 12 isolates identified 2 distinct Campylobacter jejuni subtypes (1 subtype/wave). The town began water chlorination, after which water testing detected coliforms. One dead-end ultrafiltration sample yielded nonculturable Campylobacter and avian-specific fecal rRNA genomic material. Our investigation implicated contaminated, untreated, municipal water as the source. Results of microbial source tracking supported mitigation with continued water chlorination. No further campylobacteriosis cases attributable to water were reported.

Research

• Age- and Gender-Specific Differences in Lyme Disease Health-Related Behaviors, Ontario, Canada, 2015–2022
  J. A. Adams et al.
• Temporal Characterization of Prion Shedding in Secreta of White-Tailed Deer in Longitudinal Study of Chronic Wasting Disease, United States
  N. D. Denkers et al. View Abstract

  Chronic wasting disease (CWD) affects cervids in North America, Asia, and Scandinavia. CWD is unique in its efficient spread, partially because of contact with infectious prions shed in secreta. To assess temporal profiles of CWD prion shedding, we collected saliva, urine, and feces from white-tailed deer for 66 months after exposure to low oral doses of CWD-positive brain tissue or saliva. We analyzed prion seeding activity by using modified amyloid amplification assays incorporating iron oxide bead extraction, which improved CWD detection and reduced false positives. CWD prions were detected in feces, urine, and saliva as early as 6 months postinfection. More frequent and consistent shedding was observed in deer homozygous for glycine at prion protein gene codon 96 than in deer expressing alternate genotypes. Our findings demonstrate that improved amplification methods can be used to identify early antemortem CWD prion shedding, which might aid in disease surveillance of cervids.

• One Health Investigation into Mpox and Pets, United States
  C. N. Morgan et al. View Abstract

  Monkeypox virus (MPXV) is zoonotic and capable of infecting many mammal species. However, whether common companion animals are susceptible to MPXV infection is unclear. During July 2022–March 2023, we collected animal and environmental swab samples within homes of confirmed human mpox case-patients and tested for MPXV and human DNA by PCR. We also used ELISA for orthopoxvirus antibody detection. Overall, 12% (22/191) of animal and 25% (14/56) of environmental swab samples from 4 households, including samples from 4 dogs and 1 cat, were positive for MPXV DNA, but we did not detect viable MPXV or orthopoxvirus antibodies. Among MPXV PCR-positive swab samples, 82% from animals and 93% the environment amplified human DNA with a statistically significant correlation in observed cycle threshold values. Our findings demonstrate likely DNA contamination from the human mpox cases. Despite the high likelihood for exposure, however, we found no indications that companion animals were infected with MPXV.

• Associations between Minority Health Social Vulnerability Index Scores, Rurality, and Histoplasmosis Incidence, 8 US States
  D. J. Smith et al. View Abstract

  To explore associations between histoplasmosis and race and ethnicity, socioeconomic status, and rurality, we conducted an in-depth analysis of social determinants of health and histoplasmosis in 8 US states. Using the Minority Health Social Vulnerability Index (MH SVI), we analyzed county-level histoplasmosis incidence (cases/100,000 population) from the 8 states by applying generalized linear mixed hurdle models. We found that histoplasmosis incidence was higher in counties with limited healthcare infrastructure and access as measured by the MH SVI and in more rural counties. Other social determinants of health measured by the MH SVI tool either were not significantly or were inconsistently associated with histoplasmosis incidence. Increased awareness of histoplasmosis, more accessible diagnostic tests, and investment in rural health services could address histoplasmosis-related health disparities.

• Population Structure and Antimicrobial Resistance in Campylobacter jejuni and C. coli Isolated from Humans with Diarrhea and from Poultry, East Africa
  N. P. French et al. View Abstract

  Campylobacteriosis and antimicrobial resistance (AMR) are global public health concerns. Africa is estimated to have the world’s highest incidence of campylobacteriosis and a relatively high prevalence of AMR in Campylobacter spp. from humans and animals. Few studies have compared Campylobacter spp. isolated from humans and poultry in Africa using whole-genome sequencing and antimicrobial susceptibility testing. We explored the population structure and AMR of 178 Campylobacter isolates from East Africa, 81 from patients with diarrhea in Kenya and 97 from 56 poultry samples in Tanzania, collected during 2006–2017. Sequence type diversity was high in both poultry and human isolates, and some sequence types were common. The estimated prevalence of multidrug resistance, defined as resistance to >3 antimicrobial classes, was higher in poultry isolates (40.9%, 95% credible interval 23.6%–59.4%) than in human isolates (2.5%, 95% credible interval 0.3%–6.8%), underlining the importance of antimicrobial stewardship in livestock systems.

• Rapid Increase in Seroprevalence of Borrelia burgdorferi Antibodies among Dogs, Northwestern North Carolina, USA, 2017–2021
  P. K. Pretsch et al. View Abstract

  We evaluated spatial-temporal risk for Lyme disease in northwestern North Carolina, USA, by using individual-level canine Borrelia burgdorferi seroprevalence data collected during 2017–2021 at routine veterinary screenings for tickborne diseases. Seroprevalence in dogs increased from 2.2% (47/2,130) in 2017 to 11.2% (339/3,033) in 2021. The percentage of incident seropositivity increased from 2.1% (45/2,130) in 2017 to 7.6% (231/3,033) in 2021. Exploratory geographic analyses found canine seroprevalence shifted from clustered (2017, Moran’s I = 0.30) to dispersed (2021, Moran’s I = −0.20). Elevation, slope, aspect, and forest land cover density were associated with canine seroprevalence within various household buffer regions in 2017. Slope was associated with seroprevalence at the household level in 2021. Results support the use of individual-level canine seroprevalence data for monitoring human risk for Lyme disease. Establishing sentinel veterinary clinics within Lyme disease–emergent communities might promote prevention and control efforts and provide opportunities for educational and behavioral interventions.

• Pathogenicity of Highly Pathogenic Avian Influenza A(H5N1) Viruses Isolated from Cats in Mice and Ferrets, South Korea, 2023
  I. Kim et al. View Abstract

  The prevalence of highly pathogenic avian influenza (HPAI) A(H5N1) viruses has increased in wild birds and poultry worldwide, and concomitant outbreaks in mammals have occurred. During 2023, outbreaks of HPAI H5N1 virus infections were reported in cats in South Korea. The H5N1 clade 2.3.4.4b viruses isolated from 2 cats harbored mutations in the polymerase basic protein 2 gene encoding single amino acid substitutions E627K or D701N, which are associated with virus adaptation in mammals. Hence, we analyzed the pathogenicity and transmission of the cat-derived H5N1 viruses in other mammals. Both isolates caused fatal infections in mice and ferrets. We observed contact infections between ferrets, confirming the viruses had high pathogenicity and transmission in mammals. Most HPAI H5N1 virus infections in humans have occurred through direct contact with poultry or a contaminated environment. Therefore, One Health surveillance of mammals, wild birds, and poultry is needed to prevent potential zoonotic threats.

• Economic Analysis of National Program for Hepatitis C Elimination, Israel, 2023
  Y. Dadon et al. View Abstract

  In 2021, the Israel Ministry of Health began a national hepatitis C elimination program. Implementing a World Health Organization goal, Israel’s program involved targeted screening, barrier minimization, workup simplification, awareness campaigns, and a patient registry. We evaluated program costs for testing and treatment. By May 15, 2023, the program had identified 865,382 at-risk persons, of whom 555,083 (64.3%) were serologically screened for hepatitis C virus (HCV), which was detected in 24,361 (4.4%). Among 20,928 serologically positive patients, viremia was detected in 13,379 (63.9%), of whom 10,711 (80%) were treated, and 4,618 (96.5%) of 4,786 persons receiving posttreatment HCV RNA testing had sustained virologic response. We estimated costs of ₪14,426 (new Israel shekel; ≈$3,606 USD) per person whose HCV infection was diagnosed and successfully treated. The program yielded screening and treatment in almost two thirds of the identified at-risk population. Although not eliminated, HCV prevalence will likely decrease substantially by the 2030 target.

• Evidence of Lineage 1 and 3 West Nile Virus in Person with Neuroinvasive Disease, Nebraska, USA, 2023
  E. Davis et al. View Abstract

  West Nile virus (WNV) is the most common cause of human arboviral disease in the contiguous United States, where only lineage 1 (L1) WNV had been found. In 2023, an immunocompetent patient was hospitalized in Nebraska with West Nile neuroinvasive disease and multisystem organ failure. Testing at the Centers for Disease Control and Prevention indicated an unusually high viral load and acute antibody response. Upon sequencing of serum and cerebrospinal fluid, we detected lineage 3 (L3) and L1 WNV genomes. L3 WNV had previously only been found in Central Europe in mosquitoes. The identification of L3 WNV in the United States and the observed clinical and laboratory features raise questions about the potential effect of L3 WNV on the transmission dynamics and pathogenicity of WNV infections. Determining the distribution and prevalence of L3 WNV in the United States and any public health and clinical implications is critical.

• Epidemiologic Quantities for Monkeypox Virus Clade I from Historical Data with Implications for Current Outbreaks, Democratic Republic of the Congo
  V. Marziano et al. View Abstract

  We used published data from outbreak investigations of monkeypox virus clade I in the Democratic Republic of the Congo to estimate the distributions of critical epidemiological parameters. We estimated a mean incubation period of 9.9 days (95% credible interval [CrI] 8.5–11.5 days) and a mean generation time of 17.2 days (95% CrI 14.1–20.9 days) or 11.3 days (95% CrI 9.4–14.0 days), depending on the considered dataset. Presymptomatic transmission was limited. Those estimates suggest generally slower transmission dynamics in clade I than in clade IIb. The time-varying reproduction number for clade I in the Democratic Republic of the Congo was estimated to be below the epidemic threshold in the first half of 2024. However, in the South Kivu Province, where the newly identified subclade Ib has been associated with sustained human-to-human transmission, we estimated an effective reproduction number above the epidemic threshold (95% CrI 0.96–1.27).

• Early Introductions of Candida auris Detected by Wastewater Surveillance, Utah, USA, 2022–2023
  J. Chavez et al. View Abstract

  Candida auris is considered a nosocomial pathogen of high concern and is currently spreading across the United States. Infection control measures for C. auris focus mainly on healthcare facilities, yet transmission levels may already be significant in the community before outbreaks are detected in healthcare settings. Wastewater-based epidemiology (culture, quantitative PCR, and whole-genome sequencing) can potentially gauge pathogen transmission in the general population and lead to early detection of C. auris before it is detected in clinical cases. To learn more about the sensitivity and limitations of wastewater-based surveillance, we used wastewater-based methods to detect C. auris in a southern Utah jurisdiction with no known clinical cases before and after the documented transfer of colonized patients from bordering Nevada. Our study illustrates the potential of wastewater-based surveillance for being sufficiently sensitive to detect C. auris transmission during the early stages of introduction into a community.

• Virulence of Burkholderia pseudomallei ATS2021 Unintentionally Imported to United States in Aromatherapy Spray
  C. K. Cote et al. View Abstract

  In the United States in 2021, an outbreak of 4 cases of Burkholderia pseudomallei, the etiologic agent of melioidosis and a Tier One Select Agent (potential for deliberate misuse and subsequent harm), resulted in 2 deaths. The causative strain, B. pseudomallei ATS2021, was unintentionally imported into the United States in an aromatherapy spray manufactured in India. By analyzing virulence, we established that ATS2021 represents a virulent strain of B. pseudomallei capable of robust formation of biofilm at physiologic temperatures that may contribute to virulence. By using mouse melioidosis models, we determined median lethal dose estimates and analyzed the bacteriologic and histopathologic characters of the organism, particularly the potential neurologic pathogenesis that is probably associated with the bimA_Bm allele identified in B. pseudomallei strain ATS2021. Our data, combined with previous case reports and the identification of endemic B. pseudomalleistrains in Mississippi, support the concept that melioidosis is emerging in the United States.

• Bartonella spp. in Phlebotomine Sand Flies, Brazil
  D. Lee et al. View Abstract

  Bartonella spp. are opportunistic, vectorborne bacteria that can cause disease in both animals and humans. We investigated the molecular occurrence of Bartonella spp. in 634 phlebotomine sand fly specimens, belonging to 44 different sand fly species, sampled during 2017–2021 in north and northeastern Brazil. We detected Bartonella sp. DNA in 8.7% (55/634) of the specimens by using a quantitative real-time PCR targeting the 16S-23S internal transcribed spacer intergenic region. Phylogenetic analysis positioned the Lutzomyia longipalpis sand fly–associated Bartonella gltA gene sequence in the same subclade as Bartonella ancashensis sequences and revealed a Bartonella sp. sequence in a Dampfomyia beltrani sand fly from Mexico. We amplified a bat-associated Bartonella nuoG sequence from a specimen of Nyssomyia antunesi sand fly. Our findings document the presence of Bartonella DNA in sand flies from Brazil, suggesting possible involvement of these insects in the epidemiologic cycle of Bartonella species.

Dispatches

• Dengue Virus Serotype 3 Origins and Genetic Dynamics, Jamaica
  S. A. Redman et al. View Abstract

  We identified 3 clades of dengue virus serotype 3 belonging to genotype III isolated during 2019–2020 in Jamaica by using whole-genome sequencing and phylogenomic and phylogeographic analyses. The viruses likely originated from Asia in 2014. Newly expanded molecular surveillance efforts in Jamaica will guide appropriate public health responses.

• Circovirus Hepatitis in Immunocompromised Patient, Switzerland
  B. Hamelin et al. View Abstract

  We identified a novel human circovirus in an immunocompromised 66-year-old woman with sudden onset of self-limiting hepatitis. We detected human circovirus 1 (HCirV-1) transcripts in hepatocytes and the HCirV-1 genome long-term in the patient’s blood, stool, and urine. HCirV-1 is an emerging human pathogen that persists in susceptible patients.

• Oxacillinase-484–Producing Enterobacterales, France, 2018–2023
  C. Emeraud et al. View Abstract

  We examined the emergence and characteristics of oxacillinase-484–producing Enterobacterales in France during 2012–2023. Genomic analysis identified 2 predominant sequence types in Escherichia coli: ST410 and ST1722. Plasmid analysis revealed that bla_OXA-484 genes were carried mostly on an IncX3-type plasmid associated with genetic elements including insertion sequences IS3000 and ISKpn19.

• Highly Pathogenic Avian Influenza A Virus in Wild Migratory Birds, Qinghai Lake, China, 2022
  X. Zhang et al. View Abstract

  In July 2022, an outbreak of highly pathogenic avian influenza A(H5N1) virus clade 2.3.4.4b occurred among migratory birds at Qinghai Lake in China. The virus circulated in June, and reassortants emerged after its introduction into the area. Surveillance in 2023 showed that the virus did not establish a stable presence in wild waterfowl.

• Investigation of a Human Case of Francisella tularensis Infection, United Kingdom, 2023
  A. Thompson et al. View Abstract

  Tularemia, caused by Francisella tularensis, is not known to occur in the United Kingdom. We report a case of tularemia diagnosed in July 2023 in a UK patient with no travel in the 6 weeks before symptom onset. We describe the subsequent multiagency investigation into possible routes of acquisition.

• Mpox Epidemiology and Vaccine Effectiveness, England, 2023
  H. Charles et al. View Abstract

  Reported mpox cases in England continued at a low but steady frequency during 2023. Of 137 cases reported in 2023, approximately half were acquired overseas and half were in vaccinated persons. Estimated effectiveness of 2-dose vaccine was 80%, and no vaccinated mpox patient was hospitalized.

• Presumed Transmission of 2 Distinct Monkeypox Virus Variants from Central African Republic to Democratic Republic of the Congo
  E. Vakaniaki et al. View Abstract

  We linked 4 mpox cases in South Ubangi, Democratic Republic of the Congo, to transboundary transmission from Central African Republic. Viral genome sequencing demonstrated that the monkeypox virus sequences belonged to distinct clusters of subclade Ia. This finding demonstrates the borderless nature of mpox and highlights the need for vigilant regional surveillance.

• Autochthonous Human Babesia divergens Infection, England
  G. A. Zabala et al. View Abstract

  We describe a case of autochthonous human Babesia divergens infection in an immunocompetent woman in England. The patient had fever, hemolysis, and multiorgan failure, and 18% parasitemia. We confirmed B. divergens by 18S rDNA PCR and sequencing. Clinicians should consider babesiosis as a differential diagnosis in patients with unexplained hemolysis.

• Rift Valley Fever Epizootic, Rwanda, 2022
  E. Remera et al. View Abstract

  A Rift Valley fever epizootic affected livestock in Rwanda during March–October 2022. We confirmed 3,112 infections with the virus, including 1,342 cases, 1,254 abortions, and 516 deaths among cattle, goats, and sheep. We recommend a One Health strategy for investigations and response to protect animal and human health.

• Highly Pathogenic Avian Influenza A(H5N1) Virus Clade 2.3.4.4b Infections in Seals, Russia, 2023
  I. Sobolev et al. View Abstract

  Highly pathogenic avian influenza A(H5N1) virus was detected in dead seals on Tyuleniy Island in eastern Russia, in the Sea of Okhotsk. Viruses isolated from dead northern fur seals belong to clade 2.3.4.4b and are closely related to viruses detected predominantly in the Russian Far East and Japan in 2022–2023.

• Chlorine Inactivation of Elizabethkingia spp. in Water
  D. A. Holcomb et al. View Abstract

  We performed chlorine inactivation experiments for Elizabethkingia anophelis and E. meningoseptica bacterial strains from clinical and environmental sources. Free chlorine concentration × contact time values <0.04 mg·min/L achieved 99.9% inactivation of Elizabethkingia species, indicating chlorine susceptibility. Measures to control biofilm producing pathogens in plumbing are needed to prevent Elizabethkingia bacterial infections.

• Oropouche Fever, Cuba, May 2024
  A. Benitez et al. View Abstract

  Phylogenetic analyses showed that the virus responsible for a May 2024 Oropouche fever outbreak in Cuba was closely related to viruses from Brazil in 2023. Pools of Ceratopogonidae spp. biting midges and Culex quinquefasciatus mosquitoes were positive for Oropouche viral RNA. No cases were severe. Virus extension to new areas may increase case numbers and severity.

• Bluetongue Virus in the Iberian Lynx (Lynx pardinus), 2010–2022
  J. Caballero-Gómez et al. View Abstract

  Clinical infection and death caused by bluetongue virus infection has been reported in the Eurasian lynx. Bluetongue virus surveillance in the Iberian lynx revealed widespread and repeated exposure to serotypes 1 and 4 in wild and captive populations of this species. This exposure is possibly from a spillover event from sympatric ruminants.

• Clustering of Polymorphic Membrane Protein E Clade in Chlamydia trachomatis Lineages from Men who Have Sex with Men
  M. Mitobe et al. View Abstract

  Several Chlamydia trachomatis lineages identified through outer membrane protein A genotyping or multilocus sequence typing have been circulating worldwide among men who have sex with men. In a study in Tokyo, Japan, we demonstrate that such lineages commonly belong to a specific polymorphic membrane protein E clade across genotypes.

Research Letters

• Fatal Renal Abscess Caused by Porphyromonas gingivalis and Subcapsular Hemorrhage, Japan
  Y. Atagi et al. View Abstract

  A 61-year-old man in Japan with abdominal pain was suspected of having a renal tumor. Despite initial treatment, his condition rapidly deteriorated, leading to death. Postmortem examination revealed a renal abscess and sepsis caused by Porphyromonas gingivalis. This case underscores the need to consider atypical pathogens in renal masses.

• Migration of Amblyomma maculatum Ticks and Rickettsia parkeri into the Northeastern United States
  G. Molaei et al. View Abstract

  We document a case of Rickettsia parkeri rickettsiosis in a patient in Connecticut, USA, who became ill after a bite from a Gulf Coast tick (Amblyomma maculatum). We used PCR to amplify R. parkeri DNA from the detached tick. The patient showed a 4-fold rise in IgG reactive with R. parkeri antigens.

• SARS-CoV-2 and Other Coronaviruses in Rats, Berlin, Germany, 2023
  K. Wernike et al. View Abstract

  We tested 130 rats captured in Berlin for coronaviruses. SARS-CoV-2 antibodies were detected in 1 rat, but all animals were negative by reverse transcription PCR, suggesting SARS-CoV-2 was not circulating in the rat population. However, alphacoronaviruses were found. Monitoring rodent populations helps to determine coronavirus occurrence, transmission, and zoonotic potential.

• Prosthetic Valve Endocarditis Caused by Pasteurella dagmatis, Germany
  F. A. Rottmann et al. View Abstract

  An 81-year-old male patient in Germany had prosthetic valve endocarditis caused by Pasteurella dagmatis after a domestic cat bite. We surgically treated a paravalvular abscess and administered definitive antibiotic therapy consisting of penicillin G and levofloxacin. The patient was discharged from the intensive-care unit in good condition 21 days after the surgery.

• Spatiotemporal Epidemiology of Oropouche Fever, Brazil, 2015–2024
  P. Martins-Filho et al. View Abstract

  We assessed the spatiotemporal dynamics of Oropouche fever in Brazil during 2015–2024. We found the number of cases substantially increased during that period, particularly in the Amazon region. Our findings underscore the need for improved surveillance and public health measures in response to the disease’s potential spread beyond endemic areas.

• Infectious Disease Physicians’ Knowledge and Practices Regarding Wastewater Surveillance, United States, 2024
  C. Adams et al. View Abstract

  A survey of US infectious disease physicians indicated that few regularly reviewed wastewater surveillance (WWS) data but many reported examples of the effect or potential effect of WWS on clinical practice. WWS data can be useful for physicians, but increased communication between public health professionals and physicians regarding WWS could improve its utility.

• Correlation Between Viral Wastewater Concentration and Respiratory Tests, Oregon
  N. Lininger et al. View Abstract

  We evaluated the association between wastewater concentration and weekly percent positivity of patient testing for SARS-CoV-2, influenza, and respiratory syncytial virus in Oregon, USA. We found strong, positive correlations for SARS-CoV-2 (ρ = 0.84, p<0.001), influenza (ρ = 0.73, p<0.001) and respiratory syncytial virus (ρ = 0.69, p<0.001).

• Fort Sherman Virus Infection in Human, Peru, 2020
  E. F. de Oliveira-Filho et al. View Abstract

  Fort Sherman virus (FSV) was isolated in Panama in 1985 from a US soldier. We report a case of human FSV infection in a febrile patient from northern coastal Peru in 2020. FSV infections spanning ≈35 years and a distance of 2,000 km warrant diagnostics, genomic surveillance, and investigation of transmission cycles.

• Respiratory Syncytial Virus Prevalence and Risk Factors among Healthy Term Infants, United States
  F. Cacho et al. View Abstract

  In a population-based birth cohort study of respiratory syncytial virus surveillance in the United States, 897/1,680 (53.4%) children were infected during infancy; 25/897 (2.8%) were hospitalized. Among symptomatic infants, 143/324 (44.1%) had lower respiratory tract infections. These data provide benchmarks to monitor effects of maternal vaccines and extended half-life monoclonal antibodies.

Etymologia

• Pasteurellaceae [pas′′-tər-ə-lā′-sē-ī]
  C. Partin

Corrections

• Correction: Vol. 30, Supplement 1
• Correction: Vol. 30, No. 1

Synopses

• Role of Department of Defense Global Emerging Infections Surveillance Program in Pandemic Preparedness and Response, United States
  K. Creppage et al.
• Serosurveillance for Plasmodium falciparum Malaria in Peruvian Army Peacekeeping Personnel, Central African Republic, 2021–2022
  J. A. Ventocilla et al.
• Support of Force Health Protection through Global Emerging Infections Surveillance Program, 1997–2024
  J. M. Early et al.

Research

• Molecular Surveillance of Multidrug-Resistant Bacteria among Refugees from Afghanistan in 2 US Military Hospitals during Operation Allies Refuge, 2021
  C. Anderson et al.
• Scrub Typhus Outbreak among Soldiers in Coastal Training Area, Australia, 2022
  R. Suhr et al.
• Molecular Characterization of Noroviruses Causing Acute Gastroenteritis Outbreaks among US Military Recruits, 2013–2023
  M. S. Anderson et al.

Perspective

• Flexible Development Programs for Antibacterial Drugs to Address Unmet Medical Needs
  M. Ghosh et al.

Synopses

• Clinical and Genomic Epidemiology of Coxsackievirus A21 and Enterovirus D68 in Homeless Shelters, King County, Washington, 2019–2021
  S. N. Cox et al.
• Tuberculosis Posttreatment Mortality Rates, Georgia, USA, 2008–2019
  S. Gorvetzian et al.
• Wastewater Surveillance for Poliovirus in Selected Jurisdictions, United States, 2022–2023
  E. R. Whitehouse et al.
• Vibrio parahemolyticus Food Poisoning Associated with Consumption of Oysters, Australia, 2021–2022
  E. Fearnley et al.

Research

• Risk for Facial Palsy after COVID-19 Vaccination, South Korea, 2021–2022
  D. Yoon et al.
• Spatial-Temporal Ecologic Analysis of COVID-19 Vaccination Coverage and Outcomes, Oklahoma, USA, February 2020–December 2021
  K. Ding et al.
• Detection of Predominant Azole-Resistant Candida tropicalis Genotype in Orchards Causing Human Candidemia, Taiwan
  K. Tseng et al.

Dispatches

• Clinical and Molecular Characterization of Human Burkholderia mallei Infection, Brazil
  K. G. Luz et al.
• Emerging Monkeypox Virus Sublineage C.1 Causing Community Transmission, Vietnam, 2023
  H. T. Hoa et al.
• Fatal Oropouche Virus Infections in Nonendemic Region, Brazil, 2024
  A. Bandeira et al. View Abstract

  We report acute Oropouche virus infections in 2 previously healthy women from a nonendemic region of Brazil outside the Amazon Basin. Infections rapidly progressed to hemorrhagic manifestations and fatal outcomes in 4–5 days. These cases highlight the critical need for enhanced surveillance to clarify epidemiology of this neglected disease.

• Virus Serotypes and Lineages during Dengue Outbreak, Valle del Cauca, Colombia, 2023–2024
  N. D. Grubaugh et al.
• Co-Circulation of 2 Oropouche Virus Lineages, Amazon Basin, Colombia, 2024
  J. Usuga et al.

Research Letters

• Epidemiology of Streptococcus pyogenes Disease Before, During, and After COVID-19 Pandemic, Germany, 2005–2023
  I. Burckhardt and F. Burckhardt
• Outbreak of Listeriosis Associated with Baker’s Yeast Products, Switzerland, 2022–2024
  R. Stephan et al.
• Mpox Hepatic and Pulmonary Lesions in HIV/Hepatitis B Virus Co-Infected Patient, France
  R. Calin et al.

Letter

• Foodborne Outbreak Size Is Dependent on How the Outbreak Is Detected
  C. W. Hedberg et al.

Research

• Cost-Effectiveness Analysis of Japanese Encephalitis Vaccination for Children <15 Years of Age, Bangladesh
  A. Nguyen et al.

Dispatch

• Mycobacterium leprae in Nine-Banded Armadillos (Dasypus novemcinctus), Ecuador
  D. Romero-Alvarez et al.