Emerging Infectious Diseases最新文献

We describe the epidemiology, diagnosis, and management of nontuberculous mycobacterial lymphadenitis cases detailed in a 28-year (1996–2023) multicenter cohort from Spain. The case numbers remained stable during the initial prospective phase (2013–2020), but a sharp decline was observed during 2021–2022. Disease onset occurred during spring or June in 45.9% of cases. Mycobacterium avium complex (43.1%) and M. lentiflavum (39.9%) were the most common species detected. M. lentiflavum affected mostly younger children from central Spain. The most common treatment strategy was complete surgical resection with (n = 80) or without (n = 88) antimicrobial drug treatment, followed by antimicrobial drugs alone (n = 76). Facial palsy developed in 10.4% of surgical cases. Adverse events because of antimicrobial drugs were uncommon. New fistula formation during follow-up occurred more in children managed with observation alone than in those treated with antimicrobial drugs alone (relative risk 2.7 [95% CI 1.3–5.3]; p = 0.014).

Outbreak investigation is an essential component of tuberculosis (TB) control in the United States, but its epidemiologic impact and cost-effectiveness have not been quantified. We modeled outbreak investigation activities in the United States during 2023–2032 and estimated corresponding epidemiologic impact, economic costs (in 2022 US$), and incremental cost-effectiveness ratios from the healthcare system perspective (cost per additional quality-adjusted life-year gained). We projected that outbreak investigations would result in 1,030,000 (95% uncertainty interval [UI] 376,000–1,740,000) contacts investigated, leading to 4,130 (95% UI 1,420–7,640) TB diagnoses and 104,000 (95% UI 37,600–181,000) latent TB infection diagnoses, at a total cost of US $219 million (95% UI $80–$387 million). We estimated that 5,560 (95% UI 1,720–11,400) TB cases would be averted through early detection and treatment, and the incremental cost-effectiveness of outbreak investigations, compared with no outbreak investigations, was $27,800 per quality-adjusted life-year gained (95% UI $4,580–$68,700).

In Ethiopia, dengue virus (DENV) infections have been reported in several regions; however, little is known about the genetic diversity of circulating viruses. We conducted clinical surveillance of DENV during the 2023 nationwide outbreak in Ethiopia. We enrolled patients at 3 sentinel hospital sites. Using reverse transcription PCR, we screened serum samples for 3 arboviruses and then serotyped and whole-genome sequenced DENV-positive samples. We detected DENV-1 and DENV-3 serotypes. Phylogenetic analysis identified 1 transmission cluster for DENV-1 (genotype III major lineage A) and 2 clusters for DENV-3 (genotype III major lineage B). The first DENV-3 cluster was closely related to an isolate from a 2023 dengue outbreak in Italy; the second cluster was related to isolates from India. Co-circulation of DENV-1 and DENV-3 in Ethiopia highlights the potential for severe dengue. Intensified surveillance and coordinated public health responses are needed to address the threat of severe dengue outbreaks.

Henipaviruses, such as Hendra and Nipah viruses, are major zoonotic pathogens that cause encephalitis and respiratory infections in humans and animals. The recent emergence of Langya virus in China highlights the need to understand henipavirus host diversity and geographic spread to prevent future outbreaks. Our analysis of the National Center for Biotechnology Information Virus and VIRION databases revealed ≈1,117 henipavirus sequences and 142 complete genomes. Bats (64.7%) and shrews (11.7%) dominated the host species record, and the genera Pteropus and Crocidura contained key henipavirus hosts in Asia, Australia, and Africa. Henipaviruses found in the Eidolon bat genus exhibited the highest within-host genetic distance. Phylogenetic analysis revealed batborne and rodent- or shrew-derived henipaviruses diverged ≈11,000 years ago and the first known lineage originating in Eidolon genus bats ≈9,900 years ago. Pathogenic henipaviruses diverged from their ancestors 2,800–1,200 years ago. Including atypical hosts and regions in future investigations is necessary to control future outbreaks.

Rifampin-resistant Mycobacterium tuberculosis was identified by the World Health Organization as a pathogen of public health critical importance. During 2014–2023, an increase in fluoroquinolone resistance in rifampin-resistant M. tuberculosis from Kharkiv, Ukraine, was observed. Efforts to mitigate factors contributing to resistance should be prioritized to prevent further escalation of that threat.

Mycobacterium nebraskense infection is rarely encountered; only 7 human cases have been reported worldwide since the initial report of 5 cases in Nebraska, USA, in 2004. We report 9 patients from Connecticut and 2 from Oregon, USA, who had M. nebraskense isolated from respiratory secretions; 7 patients met the American Thoracic Society/Infectious Diseases Society of America criteria for nontuberculous mycobacterial pulmonary disease. In 4 cases, the organism was isolated 1 time and caused brief or no symptoms. Most cases in Connecticut were reported after 2017. Antimicrobial drug susceptibility testing of 6 isolates showed clarithromycin susceptibility. In 2 cases, infection was refractory to treatment. The 9 Connecticut patients lived in 8 different towns; thus, a common water supply did not explain the high frequency of M. nebraskense isolation. M. nebraskense is a clinically significant cause of nontuberculous mycobacterial pulmonary disease in Connecticut; continued surveillance will be needed to determine its frequency and optimum treatment.

Mycoplasma pneumoniae infections decreased in Ohio, USA, during the COVID-19 pandemic but reemerged in 2023; >2,000 cases were reported during September 2023­–September 2024. Of 995 M. pneumoniae–positive samples, 24 (2.4%) had mutations for macrolide-resistant M. pneumoniae (MRMp). MRMp rates are low but increasing. MRMp surveillance is crucial for monitoring antimicrobial resistance.

Projections for the US 2023–24 respiratory virus season indicated a 31% decrease to a 55% increase in hospitalizations for respiratory syncytial virus, influenza, and COVID-19 compared with 2022–23, depending on circulating variants and vaccination uptake. The projections captured the tripledemic peak but missed the multiwave seasonality of COVID-19.

We report avian Chlamydia abortus pneumonia in an immunocompetent elderly patient in the Netherlands after environmental exposure to wild aquatic birds, including seabirds. New molecular surveillance studies are needed in wild and captive birds, as well as increased awareness to establish occurrence, clinical manifestations, and geographic distribution of this rare zoonotic disease.