Emerging Infectious Diseases - CDC

Emerging Infectious Diseases - CDC
Skip directly to site content
Skip directly to page options
Skip directly to A-Z link
Skip directly to A-Z link
Skip directly to A-Z link
Emerging Infectious Disease journal
ISSN: 1080-6059
Articles from
Emerging Infectious Diseases
Volume 32, Number 4—April 2026
[PDF - 18.06 MB - 204 pages]
Last Issue - Volume 32, Number 3—March 2026
Podcasts
In This Issue
Synopses
Research
Dispatches
Photo Quizzes
Research Letters
Another Dimension
Etymologia
Corrections
About the Cover
Synopses
Medscape CME Activity
Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024
[PDF - 790 KB - 7 pages]
F. Ali et al.
Snowshoe hare virus (SSHV) is an arbovirus in the California serogroup known to circulate throughout Canada and northern latitudes of the United States. The clinical spectrum of SSHV infection ranges from asymptomatic or mild febrile illness to neuroinvasive disease; neuroinvasive disease occurs more often in children and young adults. We describe a cluster of confirmed and probable SSHV meningoencephalitis cases in 3 children from Whistler, British Columbia, Canada, in the summer of 2024. We highlight the shared epidemiology, clinical manifestations, serologic diagnostic methods, and outcomes for the cases. All 3 children acquired the infection locally and made a full recovery. This case series suggests underrecognized SSHV infection prevalence that warrants enhanced surveillance and review of existing diagnostic algorithms. California serogroup viruses, including SSHV, should be recognized as a potential cause of neuroinvasive disease in North America during mosquito season, particularly when initial diagnostic testing is inconclusive.
EID
Ali F, Imperial M, Morshed M, Goldfarb DM, Gubbay JB, Hogan CA, et al. Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024. Emerg Infect Dis. 2026;32(4):477-483. https://doi.org/10.3201/eid3204.251392
AMA
Ali F, Imperial M, Morshed M, et al. Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024.
Emerging Infectious Diseases
. 2026;32(4):477-483. doi:10.3201/eid3204.251392.
APA
Ali, F., Imperial, M., Morshed, M., Goldfarb, D. M., Gubbay, J. B., Hogan, C. A....Tam, J. (2026). Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024.
Emerging Infectious Diseases
32
(4), 477-483. https://doi.org/10.3201/eid3204.251392.
Ecologic Investigative Strategies to Determine Human Plague Exposure Sites, United States, 1991–2018
[PDF - 1.00 MB - 7 pages]
R. J. Eisen et al.
Plague is a rare but potentially life-threatening fleaborne zoonotic disease caused by
Yersinia pestis
. Public health agencies in the United States use multiple concurrent epidemiologic and ecologic strategies to determine
Y. pestis
exposure sites. We reviewed 196 plague case files from 1991–2018 to describe effort and yield of implemented strategies. All files included an epidemiologic component, and 71% were followed up with environmental investigations. Environmental samples were collected for laboratory testing in 88% of investigations. The percentages of investigations yielding laboratory evidence of local transmission varied from 28% for testing live-trapped rodents to 50% for pet serology. We suggest that collection and laboratory testing of samples should be prioritized when epidemiologic investigations implicate potential exposure in an unusual setting, in areas where many people could be at risk of exposure to
Y. pestis,
or in situations where prevention activities extend beyond educational outreach and incur greater costs.
EID
Eisen RJ, Osikowicz LM, Foster E. Ecologic Investigative Strategies to Determine Human Plague Exposure Sites, United States, 1991–2018. Emerg Infect Dis. 2026;32(4):484-490. https://doi.org/10.3201/eid3204.251357
AMA
Eisen RJ, Osikowicz LM, Foster E. Ecologic Investigative Strategies to Determine Human Plague Exposure Sites, United States, 1991–2018.
Emerging Infectious Diseases
. 2026;32(4):484-490. doi:10.3201/eid3204.251357.
APA
Eisen, R. J., Osikowicz, L. M., & Foster, E. (2026). Ecologic Investigative Strategies to Determine Human Plague Exposure Sites, United States, 1991–2018.
Emerging Infectious Diseases
32
(4), 484-490. https://doi.org/10.3201/eid3204.251357.
Circulation Patterns, Genetic Diversity, and Public Health Implications of Enterovirus D68, Europe, 2014–2024
[PDF - 1.24 MB - 9 pages]
C. Andrés et al.
Enterovirus D68 (EV-D68) represents a continuing public health concern, given its association with severe respiratory illness and neurologic complications. In this study, we analyzed EV-D68 circulation and genetic evolution during 2014–2024 using data from 18 countries in Europe. Of 61,297 enterovirus-positive specimens, molecular detection and viral protein 1 sequencing identified 3,541 (6%) EV-D68 cases. A biennial circulation pattern was observed; detection rates ranged from 9% in 2014 to 0.9% in 2019. The pattern was disrupted in 2020 because of measures implemented in response to the COVID-19 pandemic, but then notable increases occurred in 2021 (14%), 2022 (10.7%), and 2024 (20.6%). Subgenogroups B3 (59.8%) and A2/D (28.0%) were predominant; A2/D reemerged as dominant in 2024. Mutation analyses revealed changes in antigenic regions. Our findings underscore the persistent adaptation and resurgence of EV-D68 after COVID-19. Continued genomic surveillance is essential to monitor transmission patterns caused by antigenic changes.
EID
Andrés C, Prats-Méndez I, Midgley S, Berginc N, González-Sánchez A, Johannesen C, et al. Circulation Patterns, Genetic Diversity, and Public Health Implications of Enterovirus D68, Europe, 2014–2024. Emerg Infect Dis. 2026;32(4):491-499. https://doi.org/10.3201/eid3204.251022
AMA
Andrés C, Prats-Méndez I, Midgley S, et al. Circulation Patterns, Genetic Diversity, and Public Health Implications of Enterovirus D68, Europe, 2014–2024.
Emerging Infectious Diseases
. 2026;32(4):491-499. doi:10.3201/eid3204.251022.
APA
Andrés, C., Prats-Méndez, I., Midgley, S., Berginc, N., González-Sánchez, A., Johannesen, C....Benschop, K. (2026). Circulation Patterns, Genetic Diversity, and Public Health Implications of Enterovirus D68, Europe, 2014–2024.
Emerging Infectious Diseases
32
(4), 491-499. https://doi.org/10.3201/eid3204.251022.
Research
Enhanced Detection of
Coccidioides
spp. Fungi from Environmental Samples Using Droplet Digital PCR
[PDF - 8.26 MB - 10 pages]
J. Segovia-Mota et al.
Coccidioidomycosis (Valley fever), caused by
Coccidioides
spp. fungi, is a reemerging, neglected fungal disease endemic to arid and semiarid regions of the Americas. Environmental detection remains challenging because of spatial heterogeneity, seasonal variability, low DNA abundance, PCR inhibitors, and lack of standardized methods. We conducted environmental surveillance in Baja California, Mexico, an understudied region near the US–Mexico border, by collecting 74 soil samples from active rodent burrows across 5 locations. We evaluated droplet digital PCR (ddPCR) for
Coccidioides
detection and compared ddPCR with nested PCR targeting the internal transcribed spacer 1 region. ddPCR demonstrated greater sensitivity, detecting
Coccidioides
spp. DNA at all sampling sites, whereas nested PCR detected
Coccidioides
spp. DNA from only 1 site. Although additional work is required to rigorously quantify sensitivity and specificity, ddPCR could help identify
Coccidioides
environmental hotspots, thus enabling public health interventions, such as warning communities of areas that pose higher risk for infection.
EID
Segovia-Mota J, Eaton-González R, Carrillo-Tripp J, Riquelme M. Enhanced Detection of Coccidioides spp. Fungi from Environmental Samples Using Droplet Digital PCR. Emerg Infect Dis. 2026;32(4):500-509. https://doi.org/10.3201/eid3204.251146
AMA
Segovia-Mota J, Eaton-González R, Carrillo-Tripp J, et al. Enhanced Detection of Coccidioides spp. Fungi from Environmental Samples Using Droplet Digital PCR.
Emerging Infectious Diseases
. 2026;32(4):500-509. doi:10.3201/eid3204.251146.
APA
Segovia-Mota, J., Eaton-González, R., Carrillo-Tripp, J., & Riquelme, M. (2026). Enhanced Detection of Coccidioides spp. Fungi from Environmental Samples Using Droplet Digital PCR.
Emerging Infectious Diseases
32
(4), 500-509. https://doi.org/10.3201/eid3204.251146.
Evaluation of Effectiveness of Autocidal Gravid Ovitraps for Preventing Zika Virus Infection, Puerto Rico, USA
[PDF - 1.75 MB - 11 pages]
Z. J. Madewell et al.
Aedes aegypti
mosquitoes drive arboviral outbreaks in tropical regions. Zika virus (ZIKV), linked to congenital and neurologic complications, caused a major outbreak in Puerto Rico, USA, in 2016, infecting ≈26% of the population. Autocidal gravid ovitraps (AGOs), pesticide-free devices targeting gravid
Ae. aegypti
mosquitoes, have been shown to reduce transmission of another arbovirus, chikungunya. During March–May 2017, we conducted a household-based serosurvey in 4 demographically similar communities in southeastern Puerto Rico, 2 with long-term AGO deployment (≈85% coverage) and 2 without, to assess effects of AGOs on ZIKV transmission. Among 271 participants
5 years of age, ZIKV seroprevalence was much lower in intervention than nonintervention communities (9.6% vs. 20.0%). Protective effects were strongest among older adults, larger households (
4 persons), and persons spending more time at home. Although study design and measurement limitations could limit generalizability of results, our findings support AGOs as sustainable nonchemical tools for reducing ZIKV infections.
EID
Madewell ZJ, Kiplagat SJ, Kellum I, Lozier MJ, Lorenzi O, Perez-Padilla J, et al. Evaluation of Effectiveness of Autocidal Gravid Ovitraps for Preventing Zika Virus Infection, Puerto Rico, USA. Emerg Infect Dis. 2026;32(4):510-520. https://doi.org/10.3201/eid3204.251206
AMA
Madewell ZJ, Kiplagat SJ, Kellum I, et al. Evaluation of Effectiveness of Autocidal Gravid Ovitraps for Preventing Zika Virus Infection, Puerto Rico, USA.
Emerging Infectious Diseases
. 2026;32(4):510-520. doi:10.3201/eid3204.251206.
APA
Madewell, Z. J., Kiplagat, S. J., Kellum, I., Lozier, M. J., Lorenzi, O., Perez-Padilla, J....Sharp, T. M. (2026). Evaluation of Effectiveness of Autocidal Gravid Ovitraps for Preventing Zika Virus Infection, Puerto Rico, USA.
Emerging Infectious Diseases
32
(4), 510-520. https://doi.org/10.3201/eid3204.251206.
Geographically Distinct Circulation of Genotype II and III St. Louis Encephalitis Virus, Texas, USA, 2009–2024
[PDF - 3.12 MB - 12 pages]
A. R. Kneubehl et al.
We conducted a retrospective genomic surveillance study of St. Louis encephalitis virus (SLEV) in Texas, USA, to determine the genotypes circulating in the region. By using a custom tiled-amplicon assay with Oxford Nanopore sequencing, we generated 63 genomes from SLEV-positive mosquito pools and viral isolates collected during 2009–2024. Phylogenomic analysis revealed temporal overlap of genotype II and III circulation, but with distinct geographic segregation. Genotype II was confined to Gulf Coast counties with sustained local transmission, whereas genotype III was only in north and west Texas, but with persistent circulation and repeated introductions. We identified the earliest known US genotype III sequences, although their phylogenetic placement leaves the entry point of genotype III into the United States unresolved. Our findings emphasize the need for clinical vigilance in West Texas, where SLEV and West Nile virus co-circulate, and suggest the Gulf Coast may be buffered against foreign genotype introduction.
EID
Kneubehl AR, Rehm DP, Curtis MW, Wimmer BM, Bolling B, Broussard A, et al. Geographically Distinct Circulation of Genotype II and III St. Louis Encephalitis Virus, Texas, USA, 2009–2024. Emerg Infect Dis. 2026;32(4):521-532. https://doi.org/10.3201/eid3204.250934
AMA
Kneubehl AR, Rehm DP, Curtis MW, et al. Geographically Distinct Circulation of Genotype II and III St. Louis Encephalitis Virus, Texas, USA, 2009–2024.
Emerging Infectious Diseases
. 2026;32(4):521-532. doi:10.3201/eid3204.250934.
APA
Kneubehl, A. R., Rehm, D. P., Curtis, M. W., Wimmer, B. M., Bolling, B., Broussard, A....Ronca, S. E. (2026). Geographically Distinct Circulation of Genotype II and III St. Louis Encephalitis Virus, Texas, USA, 2009–2024.
Emerging Infectious Diseases
32
(4), 521-532. https://doi.org/10.3201/eid3204.250934.
Confirming ERVEBO Vaccination to Support Ebola Virus Surveillance
[PDF - 2.17 MB - 10 pages]
E. Karaaslan et al.
Accurate confirmation of Ebola vaccination (ERVEBO) is essential for interpreting serologic data and assessing vaccine coverage during Ebola virus (EBOV) outbreaks. Current GP1,2-based assays cannot reliably distinguish vaccine-induced immunity from responses generated by natural infection. We developed a multiplex Luminex assay incorporating EBOV GP1,2, secreted glycoprotein (sGP), and a modified vesicular stomatitis virus nucleoprotein (VSV-P-N), a vector antigen encoded by ERVEBO but absent from wild-type EBOV. By using samples from US vaccinees and controls and a small comparison set from the Democratic Republic of the Congo, we found sGP and VSV-P-N demonstrated 100% sensitivity and
97.6% specificity for identifying vaccinees. In samples collected after a ring vaccination campaign in Guinea, combined sGP and VSV-P-N positivity confirmed vaccination in 94.8% of persons with written and 90.8% of persons with verbal confirmation of vaccination history. Our findings show that sGP and VSV-P-N provide a reliable signature of ERVEBO vaccination and support improved Ebola surveillance.
EID
Karaaslan E, Whitesell A, Malenfant J, Carson WC, Townsend M, Jolie K, et al. Confirming ERVEBO Vaccination to Support Ebola Virus Surveillance. Emerg Infect Dis. 2026;32(4):533-542. https://doi.org/10.3201/eid3204.251906
AMA
Karaaslan E, Whitesell A, Malenfant J, et al. Confirming ERVEBO Vaccination to Support Ebola Virus Surveillance.
Emerging Infectious Diseases
. 2026;32(4):533-542. doi:10.3201/eid3204.251906.
APA
Karaaslan, E., Whitesell, A., Malenfant, J., Carson, W. C., Townsend, M., Jolie, K....Bergeron, É. (2026). Confirming ERVEBO Vaccination to Support Ebola Virus Surveillance.
Emerging Infectious Diseases
32
(4), 533-542. https://doi.org/10.3201/eid3204.251906.
Seroprevalence of Crimean-Congo Hemorrhagic Fever Virus Infection in Humans and Domestic Ruminants, Democratic Republic of the Congo
[PDF - 1.86 MB - 10 pages]
B. Lombe et al.
Crimean-Congo hemorrhagic fever virus (CCHFV) was first isolated in the Democratic Republic of the Congo (DRC) in 1956. To date, only 3 sporadic human cases have been reported in the DRC, and data on CCHFV infection in livestock, which are key players in transmission, are scant. We conducted a cross-sectional seroepidemiological study on archived human and animal serum samples collected from 25 provinces across the DRC. Samples were tested using an ELISA detecting CCHFV nucleoprotein-specific antibodies. The seroprevalence of CCHFV infection in humans was 4.4% (55/1,239) and in domestic ruminants was 28.9% (322/1,114). High seroprevalences tended to correlate with increased age, specific climate conditions (e.g., tropical monsoon) and vegetation (e.g., mountain savanna) types, and higher elevation (>600 m). Our findings suggest that CCHFV actively circulates in animals and sporadically transmits to humans in the DRC, highlighting the need for continued surveillance of CCHFV infection.
EID
Lombe B, Munyeku-Bazitama Y, Kashitu-Mujinga G, Mukadi P, Mampasi H, Tshilenge C, et al. Seroprevalence of Crimean-Congo Hemorrhagic Fever Virus Infection in Humans and Domestic Ruminants, Democratic Republic of the Congo. Emerg Infect Dis. 2026;32(4):543-552. https://doi.org/10.3201/eid3204.250969
AMA
Lombe B, Munyeku-Bazitama Y, Kashitu-Mujinga G, et al. Seroprevalence of Crimean-Congo Hemorrhagic Fever Virus Infection in Humans and Domestic Ruminants, Democratic Republic of the Congo.
Emerging Infectious Diseases
. 2026;32(4):543-552. doi:10.3201/eid3204.250969.
APA
Lombe, B., Munyeku-Bazitama, Y., Kashitu-Mujinga, G., Mukadi, P., Mampasi, H., Tshilenge, C....Takada, A. (2026). Seroprevalence of Crimean-Congo Hemorrhagic Fever Virus Infection in Humans and Domestic Ruminants, Democratic Republic of the Congo.
Emerging Infectious Diseases
32
(4), 543-552. https://doi.org/10.3201/eid3204.250969.
Border Region Surveillance of Malaria Drug Resistance, Northern Burundi, 2023–2024
[PDF - 904 KB - 10 pages]
D. Niyomwungere et al.
To evaluated artemisinin partial resistance (ART-R) in malaria in Burundi, during December 2023–June 2024, we studied 423 children <5 years of age with uncomplicated
Plasmodium falciparum
malaria in 8 health facilities in the northern part of the country. After artemether/lumefantrine treatment with only the first dose directly observed, 4.5% remained parasitemic on day 3. No
pfkelch13
mutations, validated or candidate markers of ART-R, were detected. However, markers of antifolate and 4-aminoquinoline resistance were widespread: the
dhfr
triple mutant N51I/C59R/S108N was nearly fixed (92%),
dhps
double and triple mutants were common (41% and 47%), and
pfcrt
CVIET, associated with chloroquine and amodiaquine resistance, predominated (84%). Geographic differences occurred in day-3 positivity and haplotype frequencies. Although ART-R markers were absent, delayed parasite clearance and near fixation of multidrug-resistant haplotypes serve as a warning. Strengthened efficacy monitoring and regional molecular surveillance are urgently needed to prevent drug-resistant
P. falciparum
from becoming established in Burundi.
EID
Niyomwungere D, Sinarinzi P, Caspar E, Thiebaut L, Strubel P, Tibiri Y, et al. Border Region Surveillance of Malaria Drug Resistance, Northern Burundi, 2023–2024. Emerg Infect Dis. 2026;32(4):553-562. https://doi.org/10.3201/eid3204.251711
AMA
Niyomwungere D, Sinarinzi P, Caspar E, et al. Border Region Surveillance of Malaria Drug Resistance, Northern Burundi, 2023–2024.
Emerging Infectious Diseases
. 2026;32(4):553-562. doi:10.3201/eid3204.251711.
APA
Niyomwungere, D., Sinarinzi, P., Caspar, E., Thiebaut, L., Strubel, P., Tibiri, Y....Nyandwi, J. (2026). Border Region Surveillance of Malaria Drug Resistance, Northern Burundi, 2023–2024.
Emerging Infectious Diseases
32
(4), 553-562. https://doi.org/10.3201/eid3204.251711.
Accelerated Increase in
Candida auris
Bloodstream Infections during COVID-19 Pandemic, South Africa
[PDF - 4.29 MB - 10 pages]
H. Ismail et al.
The COVID-19 pandemic coincided with rising secondary bloodstream infections (BSIs) from multidrug-resistant organisms, including
Candida
auris
. To assess candidemia trends, we conducted a retrospective analysis of blood culture isolates from public and private laboratories in South Africa taken during January 2019–June 2022. We evaluated weekly aggregated
Candida
BSI counts and COVID-19 cases using segmented regression within an interrupted time-series framework. In total, 15,393 candidemia cases were identified, 70% from the private sector.
C. parapsilosis
accounted for 39% of cases, whereas
C. auris
represented 26%. The proportion of
C. auris
increased significantly from 17% in 2019 to 31% in 2021 (p<0.01). After the pandemic onset,
Candida
BSIs rose by 11 cases per week (p = 0.03), largely driven by
C. auris
(+5 cases/week; p<0.01); peaks coincided with COVID-19 waves. Those results highlight an accelerated shift toward
C. auris
in
Candida
BSIs and the urgent need for enhanced surveillance, diagnostics, and infection prevention.
EID
Ismail H, Perovic O, Mpembe R, Lowman W, Govind C, Ekermans P, et al. Accelerated Increase in Candida auris Bloodstream Infections during COVID-19 Pandemic, South Africa. Emerg Infect Dis. 2026;32(4):563-572. https://doi.org/10.3201/eid3204.251407
AMA
Ismail H, Perovic O, Mpembe R, et al. Accelerated Increase in Candida auris Bloodstream Infections during COVID-19 Pandemic, South Africa.
Emerging Infectious Diseases
. 2026;32(4):563-572. doi:10.3201/eid3204.251407.
APA
Ismail, H., Perovic, O., Mpembe, R., Lowman, W., Govind, C., Ekermans, P....Govender, N. P. (2026). Accelerated Increase in Candida auris Bloodstream Infections during COVID-19 Pandemic, South Africa.
Emerging Infectious Diseases
32
(4), 563-572. https://doi.org/10.3201/eid3204.251407.
Dengue Incidence, Seroprevalence, and Expansion Factors from Active Surveillance, Brazil, 2016–2021
[PDF - 1.68 MB - 11 pages]
E. de Barros et al.
Dengue is hyperendemic in Brazil and is underestimated by passive surveillance. To better understand dengue incidence, we conducted epidemiologic analyses among participants, 2–59 years of age, from the placebo arm of a phase 3 dengue vaccine trial. During 2016–2021, a total of 5,947 participants contributed to 22,028 person-years of follow-up. We identified and virologically confirmed dengue (VCD), Zika, and chikungunya infections. We observed VCD and chikungunya incidence heterogeneity by age, geographic location, and study year. Children 2–6 years of age experienced the highest VCD (2.33/100 person-years) and chikungunya (1.02/100 person-years) incidence. VCD peaked in 2019 (n = 148) whereas chikungunya peaked in 2017 (n = 51). VCD incidence rates from active surveillance were generally higher than those reported to the national passive surveillance system; expansion factor range was <1–9.5 by municipality. Active surveillance is critical to better understand and characterize dengue epidemiology.
EID
de Barros E, de Almeida Roediger M, Jackson M, Marks MA, Anderson EM, Esteves-Jaramillo A, et al. Dengue Incidence, Seroprevalence, and Expansion Factors from Active Surveillance, Brazil, 2016–2021. Emerg Infect Dis. 2026;32(4):573-583. https://doi.org/10.3201/eid3204.250942
AMA
de Barros E, de Almeida Roediger M, Jackson M, et al. Dengue Incidence, Seroprevalence, and Expansion Factors from Active Surveillance, Brazil, 2016–2021.
Emerging Infectious Diseases
. 2026;32(4):573-583. doi:10.3201/eid3204.250942.
APA
de Barros, E., de Almeida Roediger, M., Jackson, M., Marks, M. A., Anderson, E. M., Esteves-Jaramillo, A....Boulos, F. (2026). Dengue Incidence, Seroprevalence, and Expansion Factors from Active Surveillance, Brazil, 2016–2021.
Emerging Infectious Diseases
32
(4), 573-583. https://doi.org/10.3201/eid3204.250942.
Transmissibility and Disease Progression of Asymptomatic
Mycobacterium
tuberculosis
Infection, Lima, Peru
[PDF - 569 KB - 8 pages]
R. Wang et al.
Estimating the transmissibility of asymptomatic
Mycobacterium tuberculosis
infection can clarify its contribution to tuberculosis (TB) spread. We conducted a prospective cohort study in Lima, Peru, enrolling index TB patients and their household contacts (HHCs) and classifying patients by the presence of symptoms including cough, night sweats, weight loss, or fever. We followed HHCs with serial tuberculin skin testing and clinical evaluations. Among 4,296 child HHCs, adjusted estimates for baseline infection (prevalence ratio 0.62 [95% CI 0.37–1.03]), incident infection at 6 months (hazard ratio (aHR) 0.63 [95% CI 0.27–1.49]), and TB disease during 1 year of follow-up (aHR 0.74 [95% CI 0.35–1.56]) were all consistent with lower risk for infection and disease progression among HHCs of asymptomatic compared with symptomatic index patients. Although asymptomatic infections may be less transmissible than symptomatic infections, the high prevalence of asymptomatic patients in national surveys suggest that they may contribute substantially to transmission.
EID
Wang R, Huang C, Becerra MC, Calderon RI, Contreras CC, Galea JT, et al. Transmissibility and Disease Progression of Asymptomatic Mycobacterium tuberculosis Infection, Lima, Peru. Emerg Infect Dis. 2026;32(4):584-591. https://doi.org/10.3201/eid3204.251947
AMA
Wang R, Huang C, Becerra MC, et al. Transmissibility and Disease Progression of Asymptomatic Mycobacterium tuberculosis Infection, Lima, Peru.
Emerging Infectious Diseases
. 2026;32(4):584-591. doi:10.3201/eid3204.251947.
APA
Wang, R., Huang, C., Becerra, M. C., Calderon, R. I., Contreras, C. C., Galea, J. T....Murray, M. B. (2026). Transmissibility and Disease Progression of Asymptomatic Mycobacterium tuberculosis Infection, Lima, Peru.
Emerging Infectious Diseases
32
(4), 584-591. https://doi.org/10.3201/eid3204.251947.
Respirable Aerosol Production and Reduction of Avian Influenza Transmission Risk during Chicken Processing, Bangladesh
[PDF - 2.52 MB - 11 pages]
N. Rimi et al.
In Bangladesh, influenza A(H5N1) viruses are endemic in poultry. Processing infected chickens can aerosolize viruses, increasing the risk for human infections. We evaluated particulate matter (PM
2.5
) mass concentration during slaughtering and defeathering methods used in live bird markets in Bangladesh to identify solutions to reduce aerosol exposure. We slaughtered 675 chickens using cones and barrels with 3 lid types and defeathered 45 chickens using a defeathering machine with 5 lid types. We interviewed 3 slaughterers to understand method preference. For slaughtering, barrels with a solid or star-cut lid reduced PM
2.5
mass concentrations by 65%–73% compared with uncovered barrels. For defeathering, machines fully covered by a solid lid or lid with a hole and pivot door reduced PM
2.5
mass concentrations by 50% compared with machines with no lid. Slaughterers preferred barrels covered with solid lids and defeathering machines covered with solid or hinged lids. Those methods might reduce aerosol exposure during poultry processing.
EID
Rimi N, Saifullah M, Fahad M, Hossain K, Sultana R, Shanta I, et al. Respirable Aerosol Production and Reduction of Avian Influenza Transmission Risk during Chicken Processing, Bangladesh. Emerg Infect Dis. 2026;32(4):603-613. https://doi.org/10.3201/eid3204.251878
AMA
Rimi N, Saifullah M, Fahad M, et al. Respirable Aerosol Production and Reduction of Avian Influenza Transmission Risk during Chicken Processing, Bangladesh.
Emerging Infectious Diseases
. 2026;32(4):603-613. doi:10.3201/eid3204.251878.
APA
Rimi, N., Saifullah, M., Fahad, M., Hossain, K., Sultana, R., Shanta, I....Lindsley, W. G. (2026). Respirable Aerosol Production and Reduction of Avian Influenza Transmission Risk during Chicken Processing, Bangladesh.
Emerging Infectious Diseases
32
(4), 603-613. https://doi.org/10.3201/eid3204.251878.
Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin–Producing
Escherichia coli
Negative for Locus of Enterocyte Effacement, France, 2025
[PDF - 4.08 MB - 11 pages]
J. de Larminat et al.
In January 2025, the
Escherichia coli
National Reference Center of France detected an outbreak of hemolytic uremic syndrome (HUS) in adults, caused by Shiga toxin–producing
E. coli
negative for locus of enterocyte effacement (LEE). The outbreak included 18 confirmed cases of
E. coli
infection, 5 probable or possible cases detected by in-house specific PCR, and 2 additional cases from Scotland and Belgium. Whole-genome sequencing identified the outbreak strain as O77 g:K92:H18, belonging to phylogroup D; the strain harbored the Shiga toxin 2 gene variant
stx2d-
073-C165-02 and a 134-kb plasmid with enterotoxin genes (
estb-STb2
and
eltAB
). Epidemiologic investigation implicated raw-milk cheese as the contamination source. The strain represents a singular hybrid pathotype of Shiga toxin–producing and enterotoxigenic
E. coli
, expressing a K92 capsule with known cross-immunogenicity to
Neisseria meningitidis
group C, which could explain the absence of pediatric cases. Related strains have been identified in international databases since 2005, suggesting global emergence.
EID
de Larminat J, La K, Bidet P, Birgy A, Liguori S, Phlipaux P, et al. Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin–Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025. Emerg Infect Dis. 2026;32(4):592-602. https://doi.org/10.3201/eid3204.251417
AMA
de Larminat J, La K, Bidet P, et al. Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin–Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025.
Emerging Infectious Diseases
. 2026;32(4):592-602. doi:10.3201/eid3204.251417.
APA
de Larminat, J., La, K., Bidet, P., Birgy, A., Liguori, S., Phlipaux, P....Bonacorsi, S. (2026). Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin–Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025.
Emerging Infectious Diseases
32
(4), 592-602. https://doi.org/10.3201/eid3204.251417.
Dispatches
Chronic Wasting Disease in Farmed Cervids, South Korea, 2001–2024
[PDF - 1.34 MB - 5 pages]
Y. Choi et al.
Chronic wasting disease (CWD) was identified in imported elk in South Korea in 2001 and has spread among cervids nationwide. The country’s surveillance and control policy culls cervids from any CWD-positive farms, and prevalence during 2020–2024 was <0.5%. Maintaining low prevalence in cervids will limit livestock, wildlife, and human CWD exposure.
EID
Choi Y, Lee Y, Park H, Lee Y, Mitchell G, Roh I, et al. Chronic Wasting Disease in Farmed Cervids, South Korea, 2001–2024. Emerg Infect Dis. 2026;32(4):614-618. https://doi.org/10.3201/eid3204.251046
AMA
Choi Y, Lee Y, Park H, et al. Chronic Wasting Disease in Farmed Cervids, South Korea, 2001–2024.
Emerging Infectious Diseases
. 2026;32(4):614-618. doi:10.3201/eid3204.251046.
APA
Choi, Y., Lee, Y., Park, H., Lee, Y., Mitchell, G., Roh, I....Sohn, H. (2026). Chronic Wasting Disease in Farmed Cervids, South Korea, 2001–2024.
Emerging Infectious Diseases
32
(4), 614-618. https://doi.org/10.3201/eid3204.251046.
Outbreak of Dengue Virus Serotype 3, Republic of the Marshall Islands, 2019–2021
[PDF - 569 KB - 4 pages]
T. M. León et al.
During 2019–2021, the Republic of the Marshall Islands experienced a dengue outbreak involving 1,908 cases. Environmental sanitation helped stop transmission on Ebeye island, but transmission continued for >1 year on Majuro atoll. The Pacific region urgently needs to develop vector control capacity to address future dengue outbreaks.
EID
León TM, McCready J, Chutaro E, McAllister J, Solomon B, Hapairai LK. Outbreak of Dengue Virus Serotype 3, Republic of the Marshall Islands, 2019–2021. Emerg Infect Dis. 2026;32(4):619-622. https://doi.org/10.3201/eid3204.251135
AMA
León TM, McCready J, Chutaro E, et al. Outbreak of Dengue Virus Serotype 3, Republic of the Marshall Islands, 2019–2021.
Emerging Infectious Diseases
. 2026;32(4):619-622. doi:10.3201/eid3204.251135.
APA
León, T. M., McCready, J., Chutaro, E., McAllister, J., Solomon, B., & Hapairai, L. K. (2026). Outbreak of Dengue Virus Serotype 3, Republic of the Marshall Islands, 2019–2021.
Emerging Infectious Diseases
32
(4), 619-622. https://doi.org/10.3201/eid3204.251135.
Treatment of Severe Ocular Mpox with Cidofovir and Tecovirimat
[PDF - 1.74 MB - 4 pages]
X. Brousse et al.
Mpox, a reemerging zoonotic disease since 2022, primarily affects the skin; ocular involvement is rarely reported. We present a case of mpox-caused disciform keratitis treated with a combination of cidofovir and tecovirimat. The patient recovered without residual ocular sequelae, suggesting these drugs are an option to treat ocular mpox manifestations.
EID
Brousse X, Kreidie R, Mourgues E, Fraysse L, Lahouati M, Servant V, et al. Treatment of Severe Ocular Mpox with Cidofovir and Tecovirimat. Emerg Infect Dis. 2026;32(4):623-626. https://doi.org/10.3201/eid3204.250882
AMA
Brousse X, Kreidie R, Mourgues E, et al. Treatment of Severe Ocular Mpox with Cidofovir and Tecovirimat.
Emerging Infectious Diseases
. 2026;32(4):623-626. doi:10.3201/eid3204.250882.
APA
Brousse, X., Kreidie, R., Mourgues, E., Fraysse, L., Lahouati, M., Servant, V....Cazanave, C. (2026). Treatment of Severe Ocular Mpox with Cidofovir and Tecovirimat.
Emerging Infectious Diseases
32
(4), 623-626. https://doi.org/10.3201/eid3204.250882.
Disseminated
Acanthamoeba
Infection with Necrotic Skin Lesions and Granulomatous Vasculitis, United States
[PDF - 1.39 MB - 4 pages]
M. Koshy et al.
An elderly man, on dupilumab therapy for asthma and sinus polyposis, sought care for necrotic skin lesions. Biopsy revealed granulomatous vasculitis and he received immunosuppressive therapy but worsened. We diagnosed an
Acanthamoeba
infection that was treated with multidrug therapy including nitroxoline. Clinicians should be aware of this rare etiology for infectious vasculitis.
EID
Koshy M, Flynn C, Kribis M, McNiff J, Grant M, Gleeson S. Disseminated Acanthamoeba Infection with Necrotic Skin Lesions and Granulomatous Vasculitis, United States. Emerg Infect Dis. 2026;32(4):627-630. https://doi.org/10.3201/eid3204.251201
AMA
Koshy M, Flynn C, Kribis M, et al. Disseminated Acanthamoeba Infection with Necrotic Skin Lesions and Granulomatous Vasculitis, United States.
Emerging Infectious Diseases
. 2026;32(4):627-630. doi:10.3201/eid3204.251201.
APA
Koshy, M., Flynn, C., Kribis, M., McNiff, J., Grant, M., & Gleeson, S. (2026). Disseminated Acanthamoeba Infection with Necrotic Skin Lesions and Granulomatous Vasculitis, United States.
Emerging Infectious Diseases
32
(4), 627-630. https://doi.org/10.3201/eid3204.251201.
Cardiomyopathy Caused by Coxsackievirus Strain A9 in Previously Healthy Child, Northeastern France, 2024
[PDF - 2.14 MB - 5 pages]
A. Lebreil et al.
We characterized a recombinant mosaic coxsackievirus A9 strain responsible for severe inflammatory cardiomyopathy in a previously healthy child in northeastern France in 2024 by using whole-genome sequencing. This case highlights that enterovirus species other than coxsackievirus strain B3 can cause cardiomyopathy in otherwise healthy pediatric patients.
EID
Lebreil A, Bisseux M, Mirand A, Glenet M, N’Guyen Y, Taha N, et al. Cardiomyopathy Caused by Coxsackievirus Strain A9 in Previously Healthy Child, Northeastern France, 2024. Emerg Infect Dis. 2026;32(4):631-635. https://doi.org/10.3201/eid3204.251574
AMA
Lebreil A, Bisseux M, Mirand A, et al. Cardiomyopathy Caused by Coxsackievirus Strain A9 in Previously Healthy Child, Northeastern France, 2024.
Emerging Infectious Diseases
. 2026;32(4):631-635. doi:10.3201/eid3204.251574.
APA
Lebreil, A., Bisseux, M., Mirand, A., Glenet, M., N’Guyen, Y., Taha, N....Andreoletti, L. (2026). Cardiomyopathy Caused by Coxsackievirus Strain A9 in Previously Healthy Child, Northeastern France, 2024.
Emerging Infectious Diseases
32
(4), 631-635. https://doi.org/10.3201/eid3204.251574.
Whole-Genome Analysis of
Treponema pallidum
Subspecies
endemicum
among Men Who Have Sex with Men, Japan, 2020–2023
[PDF - 547 KB - 4 pages]
Y. Ohama et al.
Whole-genome sequencing of
Treponema pallidum
subsp.
endemicum
strains from men who have sex with men in Japan revealed a genetically distinct lineage from other geographic regions circulating via sexual transmission. Strengthening global molecular epidemiologic surveillance is essential for clarifying epidemiologic trends, clinical characteristics, and transmission pathways of this subspecies.
EID
Ohama Y, Imai K, Kotaka Y, Lee K, Itoda I, Nakayama S, et al. Whole-Genome Analysis of Treponema pallidum Subspecies endemicum among Men Who Have Sex with Men, Japan, 2020–2023. Emerg Infect Dis. 2026;32(4):636-639. https://doi.org/10.3201/eid3204.251045
AMA
Ohama Y, Imai K, Kotaka Y, et al. Whole-Genome Analysis of Treponema pallidum Subspecies endemicum among Men Who Have Sex with Men, Japan, 2020–2023.
Emerging Infectious Diseases
. 2026;32(4):636-639. doi:10.3201/eid3204.251045.
APA
Ohama, Y., Imai, K., Kotaka, Y., Lee, K., Itoda, I., Nakayama, S....Akeda, Y. (2026). Whole-Genome Analysis of Treponema pallidum Subspecies endemicum among Men Who Have Sex with Men, Japan, 2020–2023.
Emerging Infectious Diseases
32
(4), 636-639. https://doi.org/10.3201/eid3204.251045.
Panton-Valentine Leukocidin–Encoding Methicillin-Resistant
Staphylococcus aureus,
the Netherlands, 2023–2024
[PDF - 874 KB - 4 pages]
P. van Schelven et al.
We describe a community outbreak of Panton-Valentine leukocidin–positive methicillin-resistant
Staphylococcus aureus
(MRSA) during November 2023–June 2024 in the Netherlands. We identified a massage center as the source. Case-patients experienced skin infections and abscesses. This study highlights the importance of genomic surveillance of MRSA in distinguishing Panton-Valentine leukocidin–positive MRSA.
EID
van Schelven P, Nijhuis R, Jamin C, Goemans S, Hintaran P, van der Jagt-Zwetsloot M, et al. Panton-Valentine Leukocidin–Encoding Methicillin-Resistant Staphylococcus aureus, the Netherlands, 2023–2024. Emerg Infect Dis. 2026;32(4):640-643. https://doi.org/10.3201/eid3204.251646
AMA
van Schelven P, Nijhuis R, Jamin C, et al. Panton-Valentine Leukocidin–Encoding Methicillin-Resistant Staphylococcus aureus, the Netherlands, 2023–2024.
Emerging Infectious Diseases
. 2026;32(4):640-643. doi:10.3201/eid3204.251646.
APA
van Schelven, P., Nijhuis, R., Jamin, C., Goemans, S., Hintaran, P., van der Jagt-Zwetsloot, M....Raven, S. (2026). Panton-Valentine Leukocidin–Encoding Methicillin-Resistant Staphylococcus aureus, the Netherlands, 2023–2024.
Emerging Infectious Diseases
32
(4), 640-643. https://doi.org/10.3201/eid3204.251646.
Guillain-Barré Syndrome and Visual Impairment Associated with Emerging Oropouche Virus Lineage, Brazil, 2024
[PDF - 844 KB - 5 pages]
C. Filho et al.
We report a case of Guillain-Barré syndrome with visual impairment after confirmed Oropouche virus infection during the 2024 outbreak in Ceará, Brazil. Whole-genome sequencing revealed infection by a novel reassortant viral lineage (OROVBR_2025_2024), raising concern about the neurovirulence of this emerging orthobunyavirus strain.
EID
Filho C, Carvalho F, Neto A, Maia A, Rossi M, Pitombeira M, et al. Guillain-Barré Syndrome and Visual Impairment Associated with Emerging Oropouche Virus Lineage, Brazil, 2024. Emerg Infect Dis. 2026;32(4):644-648. https://doi.org/10.3201/eid3204.250617
AMA
Filho C, Carvalho F, Neto A, et al. Guillain-Barré Syndrome and Visual Impairment Associated with Emerging Oropouche Virus Lineage, Brazil, 2024.
Emerging Infectious Diseases
. 2026;32(4):644-648. doi:10.3201/eid3204.250617.
APA
Filho, C., Carvalho, F., Neto, A., Maia, A., Rossi, M., Pitombeira, M....de Góes Cavalcanti, L. (2026). Guillain-Barré Syndrome and Visual Impairment Associated with Emerging Oropouche Virus Lineage, Brazil, 2024.
Emerging Infectious Diseases
32
(4), 644-648. https://doi.org/10.3201/eid3204.250617.
Rapid Spread of Recombinant African Swine Fever Virus Genotypes I and II, Vietnam, 2023–2024
[PDF - 1.09 MB - 4 pages]
T. Nguyen et al.
Molecular analyses of African swine fever (ASF) outbreaks in northern and central Vietnam during 2023–2024 revealed a rapid expansion (14.1%–42.2%) of recombinant ASF virus genotypes I and II. Increased prevalence and resistance to commercial ASF vaccines underscore the urgent need for better ASF control and an updated vaccine in Vietnam.
EID
Nguyen T, Kim Y, Nguyen V, Tran T, Vu N, Vu T, et al. Rapid Spread of Recombinant African Swine Fever Virus Genotypes I and II, Vietnam, 2023–2024. Emerg Infect Dis. 2026;32(4):649-652. https://doi.org/10.3201/eid3204.251688
AMA
Nguyen T, Kim Y, Nguyen V, et al. Rapid Spread of Recombinant African Swine Fever Virus Genotypes I and II, Vietnam, 2023–2024.
Emerging Infectious Diseases
. 2026;32(4):649-652. doi:10.3201/eid3204.251688.
APA
Nguyen, T., Kim, Y., Nguyen, V., Tran, T., Vu, N., Vu, T....Le, V. (2026). Rapid Spread of Recombinant African Swine Fever Virus Genotypes I and II, Vietnam, 2023–2024.
Emerging Infectious Diseases
32
(4), 649-652. https://doi.org/10.3201/eid3204.251688.
Photo Quizzes
Photo Quiz
[PDF - 1.23 MB - 4 pages]
N. Hoffmann
EID
Hoffmann N. Photo Quiz. Emerg Infect Dis. 2026;32(4):653-656. https://doi.org/10.3201/eid3204.251083
AMA
Hoffmann N. Photo Quiz.
Emerging Infectious Diseases
. 2026;32(4):653-656. doi:10.3201/eid3204.251083.
APA
Hoffmann, N. (2026). Photo Quiz.
Emerging Infectious Diseases
32
(4), 653-656. https://doi.org/10.3201/eid3204.251083.
Research Letters
Acute Febrile Illness Surveillance for Estimating Population Immunity, Dominican Republic, 2021
[PDF - 655 KB - 4 pages]
E. J. Nilles et al.
We assessed whether acute febrile illness surveillance could provide timely estimates of population immunity. In the Dominican Republic, antibody levels and inferred protection were similar between surveillance data and household survey serum samples, suggesting that surveillance platforms may offer a scalable approach to track population-level protection.
EID
Nilles EJ, Paulino C, Vasquez M, Duke W, Jarolim P, Ramm R, et al. Acute Febrile Illness Surveillance for Estimating Population Immunity, Dominican Republic, 2021. Emerg Infect Dis. 2026;32(4):660-663. https://doi.org/10.3201/eid3204.251205
AMA
Nilles EJ, Paulino C, Vasquez M, et al. Acute Febrile Illness Surveillance for Estimating Population Immunity, Dominican Republic, 2021.
Emerging Infectious Diseases
. 2026;32(4):660-663. doi:10.3201/eid3204.251205.
APA
Nilles, E. J., Paulino, C., Vasquez, M., Duke, W., Jarolim, P., Ramm, R....Lau, C. L. (2026). Acute Febrile Illness Surveillance for Estimating Population Immunity, Dominican Republic, 2021.
Emerging Infectious Diseases
32
(4), 660-663. https://doi.org/10.3201/eid3204.251205.
Seroepidemiologic Study of Oropouche Virus, Amazonas State, Brazil, 2015–2016
[PDF - 1.21 MB - 3 pages]
J. Forato et al.
We conducted a cross-sectional serosurvey for Oropouche virus (OROV) among residents of Amazonas State, Brazil, during 2015–2016. We detected OROV neutralizing antibodies in 85/814 (10.4%) participants; seroprevalence was higher in Manaus (49/440 [11.1%]) than in Coari (36/374 [9.6%]). Those findings suggest OROV circulation in Amazonas State before 2015.
EID
Forato J, Scachetti GC, Salgado BB, Singh C, Pereira NC, dos Santos Reis R, et al. Seroepidemiologic Study of Oropouche Virus, Amazonas State, Brazil, 2015–2016. Emerg Infect Dis. 2026;32(4):663-665. https://doi.org/10.3201/eid3204.250917
AMA
Forato J, Scachetti GC, Salgado BB, et al. Seroepidemiologic Study of Oropouche Virus, Amazonas State, Brazil, 2015–2016.
Emerging Infectious Diseases
. 2026;32(4):663-665. doi:10.3201/eid3204.250917.
APA
Forato, J., Scachetti, G. C., Salgado, B. B., Singh, C., Pereira, N. C., dos Santos Reis, R....Lalwani, P. (2026). Seroepidemiologic Study of Oropouche Virus, Amazonas State, Brazil, 2015–2016.
Emerging Infectious Diseases
32
(4), 663-665. https://doi.org/10.3201/eid3204.250917.
Rickettsia lanei
Rickettsiosis, Oregon, USA, 2025
[PDF - 637 KB - 3 pages]
S. G. Ladd-Wilson et al.
Using metagenomic sequencing, we identified a patient infected with
Rickettsia lanei
who was initially diagnosed with Rocky Mountain spotted fever (RMSF), a clinically similar disease caused by infection with
R. rickettsii
. Our investigation highlights the importance of clinical, epidemiologic, and laboratory partnerships to leverage the discovery of novel pathogens.
EID
Ladd-Wilson SG, Fawcett RW, Park SY, Venkatasubrahmanyam S, Lindner MS, Davis S, et al. Rickettsia lanei Rickettsiosis, Oregon, USA, 2025. Emerg Infect Dis. 2026;32(4):666-668. https://doi.org/10.3201/eid3204.251962
AMA
Ladd-Wilson SG, Fawcett RW, Park SY, et al. Rickettsia lanei Rickettsiosis, Oregon, USA, 2025.
Emerging Infectious Diseases
. 2026;32(4):666-668. doi:10.3201/eid3204.251962.
APA
Ladd-Wilson, S. G., Fawcett, R. W., Park, S. Y., Venkatasubrahmanyam, S., Lindner, M. S., Davis, S....Paddock, C. D. (2026). Rickettsia lanei Rickettsiosis, Oregon, USA, 2025.
Emerging Infectious Diseases
32
(4), 666-668. https://doi.org/10.3201/eid3204.251962.
Another Dimension
The Weight of Waiting
[PDF - 549 KB - 3 pages]
M. Diagne
In Ebola outbreaks, families wait to bury their dead until a PCR whispers yes or no. Amid outbreaks of hemorrhagic fever in Senegal, laboratories raced clocks they could not command as loved ones stood by. This essay explores the ethics and emotion of that fragile interval between sample and answer.
EID
Diagne M. The Weight of Waiting. Emerg Infect Dis. 2026;32(4):657-659. https://doi.org/10.3201/eid3204.251540
AMA
Diagne M. The Weight of Waiting.
Emerging Infectious Diseases
. 2026;32(4):657-659. doi:10.3201/eid3204.251540.
APA
Diagne, M. (2026). The Weight of Waiting.
Emerging Infectious Diseases
32
(4), 657-659. https://doi.org/10.3201/eid3204.251540.
Etymologia
Anopheles stephensi
[ә-nah′-fuhl-ēz ste′-fen-zī]
[PDF - 340 KB - 1 page]
G. Kumar and J. Kaur
EID
Kumar G, Kaur J. Anopheles stephensi [ә-nah′-fuhl-ēz ste′-fen-zī]. Emerg Infect Dis. 2026;32(4):562. https://doi.org/10.3201/eid3204.241933
AMA
Kumar G, Kaur J. Anopheles stephensi [ә-nah′-fuhl-ēz ste′-fen-zī].
Emerging Infectious Diseases
. 2026;32(4):562. doi:10.3201/eid3204.241933.
APA
Kumar, G., & Kaur, J. (2026). Anopheles stephensi [ә-nah′-fuhl-ēz ste′-fen-zī].
Emerging Infectious Diseases
32
(4), 562. https://doi.org/10.3201/eid3204.241933.
Corrections
Correction: Vol. 31, No. 4
[PDF - 207 KB - 1 page]
EID
Correction: Vol. 31, No. 4. Emerg Infect Dis. 2026;32(4):668. https://doi.org/10.3201/eid3204.c13204
AMA
Correction: Vol. 31, No. 4.
Emerging Infectious Diseases
. 2026;32(4):668. doi:10.3201/eid3204.c13204.
APA
(2026). Correction: Vol. 31, No. 4.
Emerging Infectious Diseases
32
(4), 668. https://doi.org/10.3201/eid3204.c13204.
About the Cover
Giovanni Battista Grassi and Malaria
[PDF - 1.33 MB - 3 pages]
S. Pozzi and M. A. Riva
EID
Pozzi S, Riva MA. Giovanni Battista Grassi and Malaria. Emerg Infect Dis. 2026;32(4):669-671. https://doi.org/10.3201/eid3204.ac3204
AMA
Pozzi S, Riva MA. Giovanni Battista Grassi and Malaria.
Emerging Infectious Diseases
. 2026;32(4):669-671. doi:10.3201/eid3204.ac3204.
APA
Pozzi, S., & Riva, M. A. (2026). Giovanni Battista Grassi and Malaria.
Emerging Infectious Diseases
32
(4), 669-671. https://doi.org/10.3201/eid3204.ac3204.
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
May 2026
June 2026
Volume 32, Number 5—May 2026
Synopses
Three Fatal Gestational Psittacosis Cases Caused by
Chlamydia psittaci
Strains Belonging to Closely Related Lineages, Japan
A. Nishino et al.
Gestational psittacosis is a rare infectious disease caused by
Chlamydia psittaci
that causes high maternal and fetal mortality rates. In Japan, gestational psittacosis has been reported in 7 patients, including 4 maternal deaths without antemortem diagnosis. We molecularly diagnosed
C. psittaci
infection postmortem in 3 patients treated during 2017–2024. We extracted DNA from formalin-fixed paraffin-embedded placenta, lung, and spleen tissues. Analysis of multilocus sequence typing indicated sequence type (ST) 269 in 1 patient and ST335 in 2; all 3 were closely related lineages that have not been previously reported in Japan or in animals. However, the
ompA
gene showed distinct clusters in the phylogenetic analysis. Quantitative PCR and immunostaining revealed higher amounts of
C. psittaci
detected in placenta than in lung or spleen, suggesting that proliferation of
C. psittaci
in the placenta might cause severe symptoms. ST335/ST269 lineage could be highly virulent strains for pregnant women.
Borna disease virus 1 infection causing fatal meningoencephalomyelitis in wild
European hedgehogs in known endemic areas, Germany, 2022 to 2025
E. Michelakaki et al.
Research
Zoonotic and Anthroponotic
Plasmodium
spp. Circulation between Wild Primates and Indigenous Community, Peruvian Amazon, 2007–2020
G. M. Ulloa et al.
Frequency, Duration, and Risk Factors for Diagnostic Delays Associated with Coccidioidomycosis
D. D. Barber et al.
Investigation of and Response to Autochthonous Dengue, Los Angeles County, California, USA, August–November 2024
A. M. Vaughan et al.
Dengue is not endemic in the continental United States; most cases occur in returning travelers. During August–November 2024, a total of 14 locally acquired cases of dengue were identified in Los Angeles County, California, USA. Epidemiologic evidence indicates that locally acquired cases occurred in several neighborhoods, suggesting short transmission chains after introductions from returning travelers. In one neighborhood, evidence supported ongoing transmission for up to 7 weeks. Median patient age was 54 (range 5–79) years; 8 (57%) patients were female and 6 (43%) male, and 6 (43%) required hospitalization. Delays in healthcare seeking and diagnoses were noted; median time from symptom onset to specimen collection for dengue testing was 9 (range 2–34) days. Local dengue transmission in Los Angeles County highlights the emerging threat of mosquitoborne disease transmission in nonendemic areas and the need for rapid and coordinated public health and vector control responses to interrupt transmission.
Updated Genomic Epidemiologic Description of
Candida (Candidozyma) auris
, United States
L. A. Parnell et al.
The multidrug-resistant yeast
Candida
Candidozyma
auris
has caused several healthcare-associated outbreaks in the United States. We provide a genomic epidemiologic description of 1,535
C. auris
isolates collected in the United States during 2013–2022. We identified clades I, II, III, and IV but not clades V or VI. Median pairwise single-nucleotide polymorphism distances indicated lower intraclade relatedness for clades I (91), III (43), and IV (43), compared with clade II (1,455). Phylogenetic analysis showed regional clusters with varying predominant clades. Of 809 isolates that underwent antifungal susceptibility testing, 53 were echinocandin resistant, distributed across 3 clades; 92% (49/53) had
FKS1
hotspot mutations, which varied regionally. Our findings corroborate ongoing transmission and clonal expansion of
C. auris
, likely propagated by multiple introductions within and between geographic regions. Echinocandin resistance in multiple clades highlights the need to increase awareness, improve treatment practices, and engage in rapid public health response.
Dispatches
Detection of Human Rhinovirus B14 from Outbreak of Severe Respiratory Illness among Older Adults, France, 2024
J. Andreani et al.
Tropism and Replication Competence of Cattle Influenza A(H5N1) Genotype B3.13 Virus in Human Bronchus and Lung Tissue
K. Hui et al.
In 2024, influenza A(H5N1) genotype B3.13 viruses emerged from cattle and caused mild spillover infections in humans. Using human bronchus and lung tissue, we evaluated tropism, replication, and pathogenesis of 2 cattle influenza isolates. Those viruses showed moderate replication competence and induced robust proinflammatory responses, suggesting potential risk for human health.
Genomic Analysis of Sin Nombre Virus Genome Sequences, Northwestern United States, 2023
G. Rickard et al.
Retrospective Phylogenetic Analysis of Mayaro Virus, French Guiana, 1996–2024
A. Lagrave et al.
Serologic Surveillance of Wildlife in High Pathogenicity Avian Influenza Virus Subtype H5 Hotspot, Northeast Germany, 2023–2025
A. Günther et al.
A One Health investigation into a fatal encephalitis caused by pigeon paramyxovirus type 1 (PPMV-1) infection in France
N. Veyrenche et al.
Infection and exposure to the human tick-borne relapsing fever agent
Borrelia persica
in horses in Israel, 2025
D. Shwartz et al.
Repeated human cases of
Cryptosporidium
sp. OTUi in returned travelers: Clinical, molecular, and zoonotic perspectives
T. Larsen et al.
Yezo Virus Diversity in Tick-Bitten Patients and Ticks, Russia
Y. O. Epik et al.
Development and Validation of Real-Time PCR for Detecting
Anaplasma bovis
–Like Agent in
Dermacentor
spp. Ticks
R. C. Smith et al.
Nipah Virus Shedding in Urine from Fruit Bats, Sri Lanka, 2018–2019
C. Kohl et al.
Replication Efficiency of Contemporary Highly Pathogenic Avian Influenza A(H5N1) Virus Isolates in Human Nasal Epithelium Model
M. Flagg et al.
HPAI Virus H5N1 Clade 2.3.4.4b and Mass Mortality in Eurasian Cranes, Germany, 2025
A. Günther et al.
Orthopoxvirus
Antibodies in Feral Mammals in Mpox Outbreak Areas, Nigeria, 2021–2022
A. Adedeji et al.
Photo Quiz
Photo Quiz
D. Raele
Research Letters
Genomic Surveillance of Lassa Virus through In-Country Sequencing, Guinea
J. Camara et al.
Highly Pathogenic Avian Influenza A(H5N1) Virus RNA in Bovine Semen, California, USA, 2024
A. Lim et al.
Since March 2024, highly pathogenic avian influenza (HPAI) A(H5N1) virus has infected dairy cattle in the United States, prompting concern about novel transmission routes. During an outbreak in California, HPAI H5N1 RNA was detected in an asymptomatic bull’s semen. Although infectious virus was not isolated, semen-associated transmission risks and biosecurity practices remain a concern.
Herpes Simplex Virus 1 in Trigeminal Ganglia of Trafficked Neotropical Primates
F. Vilchez-Delgado et al.
Unmitigated serial interval and intervention efficiency in a school-based outbreak of pertussis, South Korea, 2024
A. R. Akhmetzhanov et al.
Borrelia turicatae
in Ticks from Animals in a Public Park, Aguascalientes, Mexico
E. Vázquez-Guerrero et al.
Bartonella clarridgeiae
Endocarditis and Aortic Root Abscess, Australia, 2020
M. Cribb and S. Coghill
Letters
Comment on Chagas Disease, an Endemic Disease in the United States
P. T. Cantey et al.
Evidence of Rat Hepatitis E Virus Circulation through Wastewater Surveillance, Central Argentina
F. Abravanel et al.
Chagas Disease, an Endemic Disease in the United States
N. L. Beatty et al.
Books and Media
The Big One: How We Must Prepare for Future Deadly Pandemics
C. Dillingham et al.
Etymologia
Borealpox [bōr′-ē-әl-poks]
J. L. Miranda
Top
Volume 32, Number 6—June 2026
Synopses
Cerebrospinal Fluid Findings among Patients with Anaplasmosis and Central Nervous Involvement, Minnesota and Wisconsin, USA
I. Dumic et al.
Group A Streptococcal Outbreak Associated with Large Congregate Shelter, Chicago, Illinois, USA, October 2023–January 2024
K. Toews et al.
Research
Characteristics of Plausible Source Cases Responsible for Recent
Mycobacterium tuberculosis
Transmission, United States, 2018–2022
S. Kammerer et al.
Wickerhamomyces anomalus
Fungemia during Healthcare-Associated Outbreak, Pereira, Colombia, 2025
K. M. Ordoñez et al.
Outbreak of
Wickerhamomyces anomalus
(formerly
Candida pelliculosa
) Bloodstream Infections, Venezuela, 2022–2023
M. Franco et al.
Association of Frailty and Frailty Trajectory with Risk for Respiratory Infectious Diseases
J. Yang et al.
Dispatches
Emergence of Ceftriaxone-Resistant
Neisseria gonorrhoeae penA
-60–Carrying Strains, Thailand, 2025
R. Kittiyaowamarn et al.
Yellow Fever Virus Surveillance in
Callithrix
spp. Marmosets during Epizootic Outbreak, Brazil, 2024–2025
M. L. Siconelli et al.
Adverse Outcomes of Travel-Related Cosmetic Procedures, 2014–2024
K. McNamara et al.
Therapeutic Challenges in Case of
Trichophyton indotineae
Dermatophytosis, Singapore, 2025
T. Foo et al.
Suspected Sexual Transmission of Dermatophilosis among Men Who Have Sex with Men, Barcelona, Spain, 2025–2026
V. Descalzo et al.
Suspected Sexual Transmission of Dermatophilosis among Men Who Have Sex with Men, Lyon and Paris, France, 2025–2026
M. Degreze et al.
Placental Vascular Pathology Associated with Congenital Lymphocytic Choriomeningitis Virus Infection, Philadelphia, Pennsylvania, USA
A. Abraham et al.
Books and Media
Dangerous Miracle: The Astonishing Rise and Looming Disaster of Antibiotics
J. P. Mills
Myriad, Microscopic and Marvelous: The World of Antoni van Leeuwenhoek
J. H. Sogin
Etymologia
Bacteria [bak-tēr′-ē-ә]
H. Santos-Dutra et al.
Top
Medscape, LLC is pleased to provide online continuing medical education (CME) for selected journal articles, allowing clinicians the opportunity to earn CME credit. In support of improving patient care, these activities have been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
CME credit is available for one year after publication.
Active CME Articles
Expires 4/10/2027
Medscape CME Activity
Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024
[PDF - 790 KB - 7 pages]
F. Ali et al.
Snowshoe hare virus (SSHV) is an arbovirus in the California serogroup known to circulate throughout Canada and northern latitudes of the United States. The clinical spectrum of SSHV infection ranges from asymptomatic or mild febrile illness to neuroinvasive disease; neuroinvasive disease occurs more often in children and young adults. We describe a cluster of confirmed and probable SSHV meningoencephalitis cases in 3 children from Whistler, British Columbia, Canada, in the summer of 2024. We highlight the shared epidemiology, clinical manifestations, serologic diagnostic methods, and outcomes for the cases. All 3 children acquired the infection locally and made a full recovery. This case series suggests underrecognized SSHV infection prevalence that warrants enhanced surveillance and review of existing diagnostic algorithms. California serogroup viruses, including SSHV, should be recognized as a potential cause of neuroinvasive disease in North America during mosquito season, particularly when initial diagnostic testing is inconclusive.
EID
Ali F, Imperial M, Morshed M, Goldfarb DM, Gubbay JB, Hogan CA, et al. Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024. Emerg Infect Dis. 2026;32(4):477-483. https://doi.org/10.3201/eid3204.251392
AMA
Ali F, Imperial M, Morshed M, et al. Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024.
Emerging Infectious Diseases
. 2026;32(4):477-483. doi:10.3201/eid3204.251392.
APA
Ali, F., Imperial, M., Morshed, M., Goldfarb, D. M., Gubbay, J. B., Hogan, C. A....Tam, J. (2026). Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024.
Emerging Infectious Diseases
32
(4), 477-483. https://doi.org/10.3201/eid3204.251392.
Expires 3/23/2027
Medscape CME Activity
Blastomyces
Urine Antigen Testing for Active Case Identification During a Blastomycosis Outbreak
[PDF - 652 KB - 8 pages]
A. W. O’Connor et al.
Blastomyces
urine antigen testing is a sensitive blastomycosis diagnostic method, but its utility for active case identification during outbreaks is unknown. We evaluated urine antigen testing for identifying blastomycosis cases during a 2023 outbreak at a Michigan, USA, paper mill and assessed demographic and clinical factors associated with test positivity. Approximately 2 months after the outbreak was recognized, we collected work and health information for 603 employees; 95% (n = 578) underwent urine antigen testing and 9% (n = 52) tested positive, including 25 previously undetected cases. Blastomycosis-like symptoms were associated with test positivity (p<0.001), but 10% of employees with positive results were asymptomatic. Recent hospitalization for blastomycosis was associated with test positivity (p = 0.02) and higher antigen levels. Further research into urine antigen testing is needed clarify its suitability for detecting mild and asymptomatic infections during outbreak investigations. Urine antigen testing had high acceptability among employees and effectively identified additional cases.
EID
O’Connor AW, Hennessee I, Callaway PC, Stanton ML, Liang X, Park J, et al. Blastomyces Urine Antigen Testing for Active Case Identification During a Blastomycosis Outbreak. Emerg Infect Dis. 2026;32(3):360-367. https://doi.org/10.3201/eid3203.250973
AMA
O’Connor AW, Hennessee I, Callaway PC, et al. Blastomyces Urine Antigen Testing for Active Case Identification During a Blastomycosis Outbreak.
Emerging Infectious Diseases
. 2026;32(3):360-367. doi:10.3201/eid3203.250973.
APA
O’Connor, A. W., Hennessee, I., Callaway, P. C., Stanton, M. L., Liang, X., Park, J....Hines, S. E. (2026). Blastomyces Urine Antigen Testing for Active Case Identification During a Blastomycosis Outbreak.
Emerging Infectious Diseases
32
(3), 360-367. https://doi.org/10.3201/eid3203.250973.
Expires 1/29/2027
Medscape CME Activity
Retrospective Case Series of Ocular Lyme Disease, 1988–2025
[PDF - 1.95 MB - 6 pages]
J. Bellafiore et al.
Reports of ocular manifestations of Lyme disease (LD) are uncommon, and signs and symptoms may be overlooked by physicians. We conducted a retrospective case series of ocular LD reported during 1988–2025. Among 27 published reports in PubMed, we noted that, in 38 cases, the most common ocular manifestation was uveitis, representing 45% of cases, followed by optic neuritis and cranial nerve palsies (including trochlear and abducens). Not all cases met Centers for Disease Control and Prevention surveillance guidelines for LD, given that some case reports were published before the current guidelines. Cases that provided microbiologic proof were 2 anterior uveitis cases, 1 case of anterior uveitis with abducens’s nerve palsy, 1 case of intermediate uveitis, and 1 case of intranuclear ophthalmoplegia. Ocular LD can have a broad variety of manifestations; therefore, physicians should be aware of those manifestations and obtain microbiologic proof for a more definitive diagnosis and epidemiologic value when possible.
EID
Bellafiore J, Mahrous A, Gurumurthy V, Capitle E, Schutzer SE. Retrospective Case Series of Ocular Lyme Disease, 1988–2025. Emerg Infect Dis. 2026;32(1):15-20. https://doi.org/10.3201/eid3201.250769
AMA
Bellafiore J, Mahrous A, Gurumurthy V, et al. Retrospective Case Series of Ocular Lyme Disease, 1988–2025.
Emerging Infectious Diseases
. 2026;32(1):15-20. doi:10.3201/eid3201.250769.
APA
Bellafiore, J., Mahrous, A., Gurumurthy, V., Capitle, E., & Schutzer, S. E. (2026). Retrospective Case Series of Ocular Lyme Disease, 1988–2025.
Emerging Infectious Diseases
32
(1), 15-20. https://doi.org/10.3201/eid3201.250769.
Expires 1/26/2027
Medscape CME Activity
Group A
Streptococcus
Meningitis, United States, 1997–2022
[PDF - 1.23 MB - 11 pages]
P. A. Hawkins et al.
Group A
Streptococcus
(GAS) causes a variety of diseases in humans but is not widely appreciated as a cause of meningitis. During 1997–2022, ten sites participating in the Active Bacterial Core Surveillance network in the United States identified GAS meningitis cases. We calculated annual incidence and case-fatality rates (CFRs) for 320 of those cases and determined antimicrobial resistance by whole-genome sequencing. Annual incidence of GAS meningitis ranged from 0.02 to 0.07 cases/100,000 persons. Children <1 year of age had the highest average annual incidence, 0.23 cases/100,000 children. GAS meningitis had a higher CFR (19.4%) than meningitis caused by group B
Streptococcus
Streptococcus pneumoniae
Neisseria meningitidis
, or
Haemophilus influenzae
. Clindamycin resistance among GAS meningitis isolates increased from 3.2% during 1997–2002 to 17.7% during 2018–2022. Clinicians should be aware that meningitis is an uncommon but severe manifestation of invasive GAS and has a higher CFR than more established meningitis etiologies.
EID
Hawkins PA, Chochua S, Prasad N, Okaro JO, Li Y, Martin T, et al. Group A Streptococcus Meningitis, United States, 1997–2022. Emerg Infect Dis. 2026;32(1):29-39. https://doi.org/10.3201/eid3201.250871
AMA
Hawkins PA, Chochua S, Prasad N, et al. Group A Streptococcus Meningitis, United States, 1997–2022.
Emerging Infectious Diseases
. 2026;32(1):29-39. doi:10.3201/eid3201.250871.
APA
Hawkins, P. A., Chochua, S., Prasad, N., Okaro, J. O., Li, Y., Martin, T....Gregory, C. J. (2026). Group A Streptococcus Meningitis, United States, 1997–2022.
Emerging Infectious Diseases
32
(1), 29-39. https://doi.org/10.3201/eid3201.250871.
Expires 12/29/2026
Medscape CME Activity
Pregnancy Outcomes after Exposure to Tuberculosis Treatment in Phase 3 Clinical Trial, 2016–2020
[PDF - 759 KB - 10 pages]
E. V. Kurbatova et al.
A previous study demonstrated noninferior efficacy of 4-month rifapentine/moxifloxacin regimen for tuberculosis (TB) treatment compared with the standard regimen. We analyzed pregnancy outcomes of women who became pregnant during the study. Among 740 women, 97 (13.1%) became pregnant. Of 102 pregnancies (in 97 participants), 30 (29.4%) participants were exposed to study drugs. Fetal loss was reported for 3/13 (23.1%) in the control regimen, 1/9 (11.1%) in the rifapentine/moxifloxacin regimen, and 1/8 (12.5%) in the rifapentine regimen. Among 21 live births in exposed pregnancies (7 in each arm), 1 infant with a congenital anomaly was reported in a participant on the rifapentine regimen. Among women receiving a short rifapentine/moxifloxacin regimen for tuberculosis who became pregnant, we observed no elevated rates of fetal losses or congenital anomalies.
EID
Kurbatova EV, Whitworth WC, Bryant KE, Dixon MG, Dooley KE, Scott NA, et al. Pregnancy Outcomes after Exposure to Tuberculosis Treatment in Phase 3 Clinical Trial, 2016–2020. Emerg Infect Dis. 2025;31(12):2219-2228. https://doi.org/10.3201/eid3112.250492
AMA
Kurbatova EV, Whitworth WC, Bryant KE, et al. Pregnancy Outcomes after Exposure to Tuberculosis Treatment in Phase 3 Clinical Trial, 2016–2020.
Emerging Infectious Diseases
. 2025;31(12):2219-2228. doi:10.3201/eid3112.250492.
APA
Kurbatova, E. V., Whitworth, W. C., Bryant, K. E., Dixon, M. G., Dooley, K. E., Scott, N. A....Phillips, P. (2025). Pregnancy Outcomes after Exposure to Tuberculosis Treatment in Phase 3 Clinical Trial, 2016–2020.
Emerging Infectious Diseases
31
(12), 2219-2228. https://doi.org/10.3201/eid3112.250492.
Expires 10/17/2026
Medscape CME Activity
Haematospirillum jordaniae
Infections after Recreational Exposure to River Water, Pennsylvania, USA, 2020
[PDF - 885 KB - 7 pages]
M. Dulcey et al.
Haematospirillum jordaniae
was first identified as a human pathogen in 2016. In this article, we describe 4 patients who had
H. jordaniae
infections identified in 2020 and who had temporally and spatially linked environmental exposures. Three of the 4 patients reported leg injuries while participating in recreational river water activities in south-central Pennsylvania, USA. In 2024, we detected
H. jordaniae
in river samples collected at locations identified during patient interviews. All patients sought emergency department services for clinical assessment; however, the causative bacterial isolate was not initially identified.
H. jordaniae
was identified as the bacterial cause months after patient treatment and discharge. Although
H. jordaniae
infections are considered rare, the true occurrence is unknown. Additional information about the organism’s ecology and environmental seasonality could guide public health messaging and increase awareness among healthcare providers.
EID
Dulcey M, DeBord KM, Bell ME, Murray MT, Szewc AM, Livingston K, et al. Haematospirillum jordaniae Infections after Recreational Exposure to River Water, Pennsylvania, USA, 2020. Emerg Infect Dis. 2025;31(11):2073-2079. https://doi.org/10.3201/eid3111.241586
AMA
Dulcey M, DeBord KM, Bell ME, et al. Haematospirillum jordaniae Infections after Recreational Exposure to River Water, Pennsylvania, USA, 2020.
Emerging Infectious Diseases
. 2025;31(11):2073-2079. doi:10.3201/eid3111.241586.
APA
Dulcey, M., DeBord, K. M., Bell, M. E., Murray, M. T., Szewc, A. M., Livingston, K....Bower, W. A. (2025). Haematospirillum jordaniae Infections after Recreational Exposure to River Water, Pennsylvania, USA, 2020.
Emerging Infectious Diseases
31
(11), 2073-2079. https://doi.org/10.3201/eid3111.241586.
Expires 9/23/2026
Medscape CME Activity
Reptile Exposure in Human Salmonellosis Cases and
Salmonella
Serotypes Isolated from Reptiles, Ontario, Canada, 2015–2022
[PDF - 1.72 MB - 10 pages]
K. Paphitis et al.
Reptile-associated outbreaks of human
Salmonella
infections are increasing in Canada, coinciding with a rise in the popularity of reptiles as pets. We conducted a retrospective analysis of surveillance data for human
Salmonella
case-patients in Ontario during 2015–2022. We compared serotypes and reptile types for those reporting domestic reptile or amphibian exposure with veterinary
Salmonella
isolates reported during the same period. Case-patients commonly reported contact with reptile types from which
Salmonella
was most frequently isolated. Some serotypes from human case-patients were closely associated with contact with specific reptile types, including
Salmonella
Paratyphi B biovar Java (
Salmonella
Paratyphi B variant L (+) tartrate +) with snakes,
Salmonella
Agbeni with turtles, and
Salmonella
Cotham,
Salmonella
Chester, and
Salmonella
Tennessee with bearded dragons.
Salmonella
was most likely to be reported from reptiles fed a carnivorous diet. Education of reptile owners could help promote proper veterinary care and reduce transmission of zoonotic infections.
EID
Paphitis K, Reid A, Golightly HR, Adams JA, Corbeil A, Majury A, et al. Reptile Exposure in Human Salmonellosis Cases and Salmonella Serotypes Isolated from Reptiles, Ontario, Canada, 2015–2022. Emerg Infect Dis. 2025;31(10):1912-1921. https://doi.org/10.3201/eid3110.241803
AMA
Paphitis K, Reid A, Golightly HR, et al. Reptile Exposure in Human Salmonellosis Cases and Salmonella Serotypes Isolated from Reptiles, Ontario, Canada, 2015–2022.
Emerging Infectious Diseases
. 2025;31(10):1912-1921. doi:10.3201/eid3110.241803.
APA
Paphitis, K., Reid, A., Golightly, H. R., Adams, J. A., Corbeil, A., Majury, A....McClinchey, H. (2025). Reptile Exposure in Human Salmonellosis Cases and Salmonella Serotypes Isolated from Reptiles, Ontario, Canada, 2015–2022.
Emerging Infectious Diseases
31
(10), 1912-1921. https://doi.org/10.3201/eid3110.241803.
Expires 9/17/2026
Medscape CME Activity
Recent Systemic Antifungal Exposure and Nonsusceptible
Candida
in Hospitalized Patients, South Africa, 2012–2017
[PDF - 1.11 MB - 11 pages]
C. Rabault et al.
Candida
bloodstream infections, and their increasing antifungal resistance, are a global concern. In this cross-sectional study, we analyzed 2,443 culture-confirmed candidemia cases reported in South Africa during 2012–2017 to assess the effect of previous antifungal exposure on nonsusceptible
Candida
infection. We classified cases by species resistance profile and patient’s antifungal use within 14 days before infection. We found that 48% of cases were caused by nonsusceptible species, and 20% of patients had prior antifungal exposure, mainly to fluconazole. In patients >90 days of age, prior antifungal use was significantly associated with nonsusceptible
Candida
bloodstream infection (adjusted OR 2.02, 95% CI 1.43–2.87; p<0.001), with species-specific effects. No such association was found in neonates and young infants, for whom hospital transmission appeared more influential. Our findings underscore the need for targeted antifungal stewardship and enhanced infection prevention to mitigate antifungal resistance in South Africa.
EID
Rabault C, Shuping L, Mpembe R, Quan V, Lanternier F, Lortholary O, et al. Recent Systemic Antifungal Exposure and Nonsusceptible Candida in Hospitalized Patients, South Africa, 2012–2017. Emerg Infect Dis. 2025;31(10):1901-1911. https://doi.org/10.3201/eid3110.250359
AMA
Rabault C, Shuping L, Mpembe R, et al. Recent Systemic Antifungal Exposure and Nonsusceptible Candida in Hospitalized Patients, South Africa, 2012–2017.
Emerging Infectious Diseases
. 2025;31(10):1901-1911. doi:10.3201/eid3110.250359.
APA
Rabault, C., Shuping, L., Mpembe, R., Quan, V., Lanternier, F., Lortholary, O....Govender, N. P. (2025). Recent Systemic Antifungal Exposure and Nonsusceptible Candida in Hospitalized Patients, South Africa, 2012–2017.
Emerging Infectious Diseases
31
(10), 1901-1911. https://doi.org/10.3201/eid3110.250359.
Expires 8/22/2026
Medscape CME Activity
Rickettsioses as Underrecognized Cause of Hospitalization for Febrile Illness, Uganda
[PDF - 1.22 MB - 10 pages]
P. W. Blair et al.
The complexity of rickettsial serodiagnostics during acute illness has limited clinical characterization in Africa. We used archived samples from sepsis (n = 259) and acute febrile illness (n = 70) cohorts in Uganda to identify spotted fever and typhus group rickettsiae by using immunofluorescence assay and clinically validated rRNA reverse transcription PCR (RT-PCR). Among 329 participants, 10.0% had rickettsial infections (n = 33; n = 20 identified with immunofluorescence assay and n = 13 by RT-PCR). Serum rRNA RT-PCR was 75.0% (95% CI 42.8–94.5%) sensitive and 91.2% (95% CI 85.8–95.1%) specific. Thrombocytopenia was more common among patients with rickettsial infections than with other nonmalarial infections (adjusted odds ratio 3.7; p = 0.003). No participants were on a tetracycline antimicrobial drug at admission. rRNA RT-PCR is a promising diagnostic strategy for identifying acute rickettsial infections. Doxycycline should be included in empiric antimicrobial drug regimens for nonmalarial febrile illness in this region.
EID
Blair PW, Alharthi S, Londoño AF, Wailagala A, Manabe YC, Dumler J. Rickettsioses as Underrecognized Cause of Hospitalization for Febrile Illness, Uganda. Emerg Infect Dis. 2025;31(9):1708-1717. https://doi.org/10.3201/eid3109.250479
AMA
Blair PW, Alharthi S, Londoño AF, et al. Rickettsioses as Underrecognized Cause of Hospitalization for Febrile Illness, Uganda.
Emerging Infectious Diseases
. 2025;31(9):1708-1717. doi:10.3201/eid3109.250479.
APA
Blair, P. W., Alharthi, S., Londoño, A. F., Wailagala, A., Manabe, Y. C., & Dumler, J. (2025). Rickettsioses as Underrecognized Cause of Hospitalization for Febrile Illness, Uganda.
Emerging Infectious Diseases
31
(9), 1708-1717. https://doi.org/10.3201/eid3109.250479.
Expires 8/21/2026
Medscape CME Activity
Severe Group A
Streptococcus
Infection among Children, France, 2022–2024
[PDF - 1.01 MB - 10 pages]
M. Colomina et al.
Suggested citation for this article
Sierra Colomina M, Flamant A, Le Balle G, Cohen JF, Berthomieu L, Leteurtre S, et al. Severe group A
Streptococcus
infection among children, France, 2022–2024. Emerg Infect Dis. 2025 Sep [
date cited
].
Group A
Streptococcus
infections have increased in Europe since September 2022. The French Pediatric Intensive Care and French Pediatric Infectious Diseases expert groups conducted a retrospective and prospective study of children who had severe group A
Streptococcus
infections during September 1, 2022–April 1, 2024, across 34 hospitals in France. A total of 402 pediatric patients (median age 4 [interquartile range 2–7.5] years; 42% girls, 58% boys) were enrolled. Cases were characterized by a low proportion of severe skin and soft tissue infections (16%), predominance of severe upper and lower respiratory tract infections (55%), and a 3.5% case-fatality rate. In multivariate analysis, hydrocortisone, corticosteroid, and vasopressor therapies were significantly associated with major sequelae or death. Molecular analysis revealed
emm1
(73.0%) and
emm12
(10.8%) strains; the M1
UK
clone represented 50% of
emm1
strains. Clinicians, researchers, and public health authorities must collaborate to mitigate the effects of GAS on child health.
EID
Colomina M, Flamant A, Le Balle G, Cohen JF, Berthomieu L, Leteurtre S, et al. Severe Group A Streptococcus Infection among Children, France, 2022–2024. Emerg Infect Dis. 2025;31(9):1698-1707. https://doi.org/10.3201/eid3109.250245
AMA
Colomina M, Flamant A, Le Balle G, et al. Severe Group A Streptococcus Infection among Children, France, 2022–2024.
Emerging Infectious Diseases
. 2025;31(9):1698-1707. doi:10.3201/eid3109.250245.
APA
Colomina, M., Flamant, A., Le Balle, G., Cohen, J. F., Berthomieu, L., Leteurtre, S....Brehin, C. (2025). Severe Group A Streptococcus Infection among Children, France, 2022–2024.
Emerging Infectious Diseases
31
(9), 1698-1707. https://doi.org/10.3201/eid3109.250245.
Expires 7/24/2026
Medscape CME Activity
Scheffersomyces spartinae
Fungemia among Pediatric Patients, Pakistan, 2020–2024
[PDF - 1.42 MB - 11 pages]
K. Jabeen et al.
Prevalence of emerging fungal infections is increasing, particularly among immunocompromised persons, children, and older persons. We report 108 cases of
Scheffersomyces spartinae
infection in pediatric patients from Karachi and other cities in Pakistan, of which 107 were identified from blood cultures. Cultures were initially misidentified as
Clavispora lusitaniae
by a biochemical assay before speciation as
S. spartinae
by whole-genome sequencing. All isolates were from children
12 years of age, and >69% were from children <1 month of age. Isolates were genetically distinct across regions of Pakistan; however, genetic diversity was low in isolates from patients in Karachi and nearby Nawabshah and had median differences of just 9 pairwise nucleotide variants. This study demonstrates
S. spartinae
is a potentially emerging pathogen in neonates and young infants in Pakistan. The findings highlight the limitations of phenotypic identification for detecting emerging fungal infections and underscore the value of molecular identification approaches.
EID
Jabeen K, Farooqi J, Simons LM, Hultquist JF, Lorenzo-Redondo R, Evans CT, et al. Scheffersomyces spartinae Fungemia among Pediatric Patients, Pakistan, 2020–2024. Emerg Infect Dis. 2025;31(8):1550-1560. https://doi.org/10.3201/eid3108.241604
AMA
Jabeen K, Farooqi J, Simons LM, et al. Scheffersomyces spartinae Fungemia among Pediatric Patients, Pakistan, 2020–2024.
Emerging Infectious Diseases
. 2025;31(8):1550-1560. doi:10.3201/eid3108.241604.
APA
Jabeen, K., Farooqi, J., Simons, L. M., Hultquist, J. F., Lorenzo-Redondo, R., Evans, C. T....Ozer, E. A. (2025). Scheffersomyces spartinae Fungemia among Pediatric Patients, Pakistan, 2020–2024.
Emerging Infectious Diseases
31
(8), 1550-1560. https://doi.org/10.3201/eid3108.241604.
Expires 7/23/2026
Medscape CME Activity
Emergence of Clade Ib Monkeypox Virus—Current State of Evidence
[PDF - 1.99 MB - 10 pages]
P. S. Satheshkumar et al.
Mpox was first identified against the backdrop of the smallpox eradication campaign. Monkeypox virus (MPXV), the causative agent of mpox, has been maintained in animal reservoirs in the forested regions of West and Central Africa as 2 distinct clades; clade I has historically caused more severe infection in Central Africa than clade II, historically found in West Africa. However, rapid reemergence and spread of both MPXV clades through novel routes of transmission have challenged the known characteristics of mpox. We summarize mpox demographic distribution, clinical severity, and case-fatality rates attributed to genetically distinct MPXV subclades and focus on MPXV clade Ib, the more recently identified subclade. Broad worldwide assistance will be necessary to halt the spread of both MPXV clades within mpox endemic and nonendemic regions to prevent future outbreaks.
EID
Satheshkumar PS, Gigante CM, Mbala-Kingebeni P, Nakazawa Y, Anderson M, Balinandi S, et al. Emergence of Clade Ib Monkeypox Virus—Current State of Evidence. Emerg Infect Dis. 2025;31(8):1516-1525. https://doi.org/10.3201/eid3108.241551
AMA
Satheshkumar PS, Gigante CM, Mbala-Kingebeni P, et al. Emergence of Clade Ib Monkeypox Virus—Current State of Evidence.
Emerging Infectious Diseases
. 2025;31(8):1516-1525. doi:10.3201/eid3108.241551.
APA
Satheshkumar, P. S., Gigante, C. M., Mbala-Kingebeni, P., Nakazawa, Y., Anderson, M., Balinandi, S....Hutson, C. L. (2025). Emergence of Clade Ib Monkeypox Virus—Current State of Evidence.
Emerging Infectious Diseases
31
(8), 1516-1525. https://doi.org/10.3201/eid3108.241551.
Expires 6/23/2026
Medscape CME Activity
Multicenter Case–Control Study of Behavioral, Environmental, and Geographic Risk Factors for Talaromycosis, Vietnam
[PDF - 829 KB - 10 pages]
L. Brown et al.
Talaromycosis is a life-threatening fungal disease that primarily affects immunocompromised persons in Southeast Asia. We conducted a multicenter, case–control study recruiting participants with advanced HIV disease in Vietnam; 205 case-patients with culture-confirmed talaromycosis were matched to 405 control-patients by age, sex, and CD4 count. Occupational exposure to tropical plants (odds ratio [OR] 1.73 [95% CI 1.10–2.73]; p = 0.017) and to farmed animals (OR 2.07 [95% CI 1.20–3.55]; p = 0.009) were independent risk factors for talaromycosis. Talaromycosis risk was higher in participants from highland regions than in persons from lowland regions (p<0.05). Participants from lowland regions who had lived or traveled to highland regions had a higher risk for talaromycosis (OR 3.15 [95% CI 1.49–6.64]; p = 0.003). This study confirms the epidemiologic correlation between talaromycosis and soil exposure and demonstrates an epidemiologic link between talaromycosis and residence in or travel to highland regions of Vietnam.
EID
Brown L, Jonat B, Ly V, Tung N, Lam PS, Thanh N, et al. Multicenter Case–Control Study of Behavioral, Environmental, and Geographic Risk Factors for Talaromycosis, Vietnam. Emerg Infect Dis. 2025;31(7):1309-1318. https://doi.org/10.3201/eid3107.250143
AMA
Brown L, Jonat B, Ly V, et al. Multicenter Case–Control Study of Behavioral, Environmental, and Geographic Risk Factors for Talaromycosis, Vietnam.
Emerging Infectious Diseases
. 2025;31(7):1309-1318. doi:10.3201/eid3107.250143.
APA
Brown, L., Jonat, B., Ly, V., Tung, N., Lam, P. S., Thanh, N....Le, T. (2025). Multicenter Case–Control Study of Behavioral, Environmental, and Geographic Risk Factors for Talaromycosis, Vietnam.
Emerging Infectious Diseases
31
(7), 1309-1318. https://doi.org/10.3201/eid3107.250143.
Expires 5/28/2026
Medscape CME Activity
Multicenter Retrospective Study of
Spiroplasma ixodetis
Infantile Cataract in 8 Countries in Europe
[PDF - 1.43 MB - 9 pages]
L. Van Os et al.
Spiroplasma ixodetis
has been reported to cause the rare combination of cataract and uveitis in infants. Through a retrospective analysis of available literature and additional unpublished cases, we identified 28 eyes from 18 infants from 8 countries in Europe with cataracts and intraocular inflammation. The cataracts were bilateral in 55.6%, unilateral in 44.4%, and progressive in 46.4% of patients. Granulomatous anterior uveitis was found in all infants. Presence of
S. ixodetis
was supported by PCR (positive in 89.3% of eyes tested), transmission electron microscopy (positive in 90% of eyes tested), or culture of aspirated lens material (positive in 87.5% of eyes tested). Treatment with macrolide antimicrobial drugs, corticosteroids, and lensectomy appeared to be effective. Two patients had a recurrence of the uveitis after lens extraction and needed prolonged treatment. To increase awareness of
S. ixodetis
, we suggest its inclusion with the organisms of the TORCH acronym.
EID
Van Os L, Cassoux N, Cholidis S, Dureau P, Farassat N, Fierz F, et al. Multicenter Retrospective Study of Spiroplasma ixodetis Infantile Cataract in 8 Countries in Europe. Emerg Infect Dis. 2025;31(6):1081-1089. https://doi.org/10.3201/eid3106.240954
AMA
Van Os L, Cassoux N, Cholidis S, et al. Multicenter Retrospective Study of Spiroplasma ixodetis Infantile Cataract in 8 Countries in Europe.
Emerging Infectious Diseases
. 2025;31(6):1081-1089. doi:10.3201/eid3106.240954.
APA
Van Os, L., Cassoux, N., Cholidis, S., Dureau, P., Farassat, N., Fierz, F....Lorenz, B. (2025). Multicenter Retrospective Study of Spiroplasma ixodetis Infantile Cataract in 8 Countries in Europe.
Emerging Infectious Diseases
31
(6), 1081-1089. https://doi.org/10.3201/eid3106.240954.
Expires 5/27/2026
Medscape CME Activity
Clinical Manifestations, Risk Factors, and Disease Burden of Rickettsiosis, Cambodia, 2007–2020
[PDF - 1.70 MB - 12 pages]
G. C. Kelly et al.
During 2007–2020, we conducted a cross-sectional prevalence study among patients with acute undifferentiated febrile illness to describe the burden and long-term epidemiology of rickettsioses in Cambodia. Serum samples were collected from 10,243 participants, along with epidemiologic data, information on clinical symptoms, demographic characteristics, and risk factors. A total of 802 (7.8%) participants met the definition for acute rickettsial infection after ruling out malaria, influenza, dengue, and chikungunya; 557 (5.4%) cases were typhus, 154 (1.5%) spotted fever, and 136 (1.3%) scrub typhus. Overall seroprevalence was 18.1% (1,857/10,243). Increased age, residence in urban settings, and recent travel to forests were significantly associated with rickettsial infection. Symptoms significantly associated with infection included rash, vomiting, and skin lesions. Our results confirm the underlying burden of rickettsioses and associated risk factors in Cambodia and highlight the need for accessible diagnostics and clinical guidance that consider rickettsioses when treating persons with acute undifferentiated febrile illness.
EID
Kelly GC, Rachmat A, Tran L, Supaprom C, Phireak H, Prom S, et al. Clinical Manifestations, Risk Factors, and Disease Burden of Rickettsiosis, Cambodia, 2007–2020. Emerg Infect Dis. 2025;31(6):1069-1080. https://doi.org/10.3201/eid3106.241752
AMA
Kelly GC, Rachmat A, Tran L, et al. Clinical Manifestations, Risk Factors, and Disease Burden of Rickettsiosis, Cambodia, 2007–2020.
Emerging Infectious Diseases
. 2025;31(6):1069-1080. doi:10.3201/eid3106.241752.
APA
Kelly, G. C., Rachmat, A., Tran, L., Supaprom, C., Phireak, H., Prom, S....Letizia, A. G. (2025). Clinical Manifestations, Risk Factors, and Disease Burden of Rickettsiosis, Cambodia, 2007–2020.
Emerging Infectious Diseases
31
(6), 1069-1080. https://doi.org/10.3201/eid3106.241752.
Expires 4/29/2026
Medscape CME Activity
Features of Invasive Aspergillosis Caused by
Aspergillus flavus
, France, 2012–2018
[PDF - 590 KB - 10 pages]
L. Bertin-Biasutto et al.
Invasive aspergillosis (IA) caused by
Aspergillus flavus
remains poorly described. We retrospectively analyzed 54 cases of IA caused by
A. flavus
reported in France during 2012–2018. Among cases, underlying IA risk factors were malignancy, solid organ transplantation, and diabetes. Most (87%, 47/54) infections were localized, of which 33 were pleuropulmonary and 13 were ear-nose-throat (ENT) infection sites. Malignancy (70% [23/33]) and solid organ transplantation (21% [7/33]) were the main risk factors in localized pulmonary infections, and diabetes mellitus was associated with localized ENT involvement (61.5%, [8/13]). Fungal co-infections were frequent in pulmonary (36%, 12/33) but not ENT IA (0 cases). Antifungal monotherapy was prescribed in 45/50 (90%) cases, mainly voriconazole (67%, 30/45). All-cause 30-day case-fatality rates were 39.2% and 90-day rates were 47.1%, and rates varied according to risk factor, IA site, and fungal co-infections. Clinicians should remain vigilant for
A. flavus
and consider it in the differential diagnosis for IA.
EID
Bertin-Biasutto L, Paccoud O, Garcia-Hermoso D, Denis B, Boukris-Sitbon K, Lortholary O, et al. Features of Invasive Aspergillosis Caused by Aspergillus flavus, France, 2012–2018. Emerg Infect Dis. 2025;31(5):896-905. https://doi.org/10.3201/eid3105.241392
AMA
Bertin-Biasutto L, Paccoud O, Garcia-Hermoso D, et al. Features of Invasive Aspergillosis Caused by Aspergillus flavus, France, 2012–2018.
Emerging Infectious Diseases
. 2025;31(5):896-905. doi:10.3201/eid3105.241392.
APA
Bertin-Biasutto, L., Paccoud, O., Garcia-Hermoso, D., Denis, B., Boukris-Sitbon, K., Lortholary, O....Lanternier, F. (2025). Features of Invasive Aspergillosis Caused by Aspergillus flavus, France, 2012–2018.
Emerging Infectious Diseases
31
(5), 896-905. https://doi.org/10.3201/eid3105.241392.
Article Quick Search
Search for articles with a simple interface. Powered by PubMed.
Advanced Search
Search for articles by multiple keywords or authors. Results are searchable and sortable. Powered by PubMed.
Articles by Country
Find articles by topic country with the article map. Results are searchable and sortable.
Spotlight Topics
Find articles on specific topics such as Ebola, Zika, and Influenza.
Article Types
Browse articles by type, such as research, letters, or dispatches.
PubMed Central
You can find all of EID’s contents on PubMed Central.
What's New
Conference summaries welcome online only
LATEST PODCAST
Quiet Moment around the Campfire
Length: 5:31
Send us online reports
Listen now or download MP3
Page created: April 21, 2026
Page reviewed: April 21, 2026
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.
ScholarOne Submission Portal
Issue Select
Campylobacteriosis Outbreak Linked to Municipal Water, Nebraska, USA, 2021
— (Length: 18:01)
Get Email Updates
To receive email updates about this page, enter your email address:
Connect and Share
audio icon
EID Podcasts
twitter icon
EID on Twitter
linkedin icon
EID on LinkedIn
insta icon
EID on Instagram
fb icon
EID on Facebook
fb icon
EID Cover Art
rss icon
Subscribe to RSS Feeds
book icon
PubMed Central
external icon
Additional CDC Resources
Morbidity and Mortality Weekly Report (MMWR)
Preventing Chronic Disease Journal
Public Health Image Library (PHIL)
Science Briefs
Vital Signs