Autochthonous Cases of Tick-Borne Encephalitis,Belgium, 2020

We report 3 confirmed autochthonous tick-borne encephalitis cases in Belgium diagnosed during summer 2020. Clinicians should include this viral infection in the differential diagnosis for patients with etiologically unexplained neurologic manifestations, even for persons without recent travel history.     

Humans infected with relapsing fever spirochete Borrelia miyamotoi, Russia

Borrelia miyamotoi is distantly related to B. burgdorferi and transmitted by the same hard-body tick species. We report 46 cases of B. miyamotoi infection in humans and compare the frequency and clinical manifestations of this infection with those caused by B. garinii and B. burgdorferi infection. All 46 patients lived in Russia and had influenza-like illness with fever as high as 39.5°C; relapsing febrile illness occurred in 5 (11%) and erythema migrans in 4 (9%). In Russia, the rate of B. miyamotoi infection in Ixodes persulcatus ticks was 1%-16%, similar to rates in I. ricinus ticks in western Europe and I. scapularis ticks in the United States. B. miyamotoi infection may cause relapsing fever and Lyme disease-like symptoms throughout the Holarctic region of the world because of the widespread prevalence of this pathogen in its ixodid tick vectors.     

Naturally acquired human Plasmodium knowlesi infection, Singapore

We report a case of naturally acquired Plasmodium knowlesi in Singapore, a malaria-free country. Diagnosis was confirmed by PCR with validated species-specific primers. In industrialized countries, free-ranging primates are a potential source of P. knowlesi human infection. P. knowlesi infection is a differential diagnosis of febrile illness acquired in Singapore.     

Estimates of Toxoplasmosis Incidence Based on Healthcare Claims Data,Germany, 2011–2016

Toxoplasmosis is a zoonotic infection contracted through Toxoplasma gondii–contaminated food, soil, or water. Seroprevalence in Germany is high, but estimates of disease incidence are scarce. We investigated incidences for various toxoplasmosis manifestations using anonymized healthcare claims data from Germany for 2011–2016. Patients with a toxoplasmosis diagnosis during the annual observational period were considered incident. The estimated incidence was adjusted to the general population age/sex distribution. We estimated an annual average of 8,047 toxoplasmosis patients in Germany. The average incidence of non–pregnancy-associated toxoplasmosis patients was 9.6/100,000 population. The incidence was highest in 2011, at 10.6 (95% CI 9.4–12.6)/100,000 population, and lowest in 2016, at 8.0 (95% CI 7.0–9.4)/100,000 population. The average incidence of toxoplasmosis during pregnancy was 40.3/100,000 pregnancies. We demonstrate a substantial toxoplasmosis disease burden in Germany. Public health and food safety authorities should implement toxoplasmosis-specific prevention programs.     

A Literature Review of Zika Virus

Zika virus is a mosquitoborne flavivirus that is the focus of an ongoing pandemic and public health emergency. Previously limited to sporadic cases in Africa and Asia, the emergence of Zika virus in Brazil in 2015 heralded rapid spread throughout the Americas. Although most Zika virus infections are characterized by subclinical or mild influenza-like illness, severe manifestations have been described, including Guillain-Barre syndrome in adults and microcephaly in babies born to infected mothers. Neither an effective treatment nor a vaccine is available for Zika virus; therefore, the public health response primarily focuses on preventing infection, particularly in pregnant women. Despite growing knowledge about this virus, questions remain regarding the virus’s vectors and reservoirs, pathogenesis, genetic diversity, and potential synergistic effects of co-infection with other circulating viruses. These questions highlight the need for research to optimize surveillance, patient management, and public health intervention in the current Zika virus epidemic.     

Myocarditis after Trimethoprim/Sulfamethoxazole Treatment for Ehrlichiosis

The manifestations of human monocytic ehrlichiosis range from a mild febrile syndrome to a severe multisystem illness. Myocardial involvement is uncommon. We report a woman, 78 years of age, who was treated with trimethoprim/sulfamethoxazole after a tick bite, in whom myocarditis was subsequently diagnosed. She recovered completely after doxycycline therapy.     

Human Case of Swine Influenza A (H1N1) Triple Reassortant Virus Infection, Wisconsin

Zoonotic infections with swine influenza A viruses are reported sporadically. Triple reassortant swine influenza viruses have been isolated from pigs in the United States since 1998. We report a human case of upper respiratory illness associated with swine influenza A (H1N1) triple reassortant virus infection that occurred during 2005 following exposure to freshly killed pigs.     

HIV感染合并肺结核肺影像学CT特征与CD4+T细胞及病毒载量的相关性

目的分析人类免疫缺陷病毒(HIV)感染合并肺结核患者肺影像学CT特征及其与外周血CD₄⁺T淋巴细胞和病毒载量水平的关系。方法选取重庆大学附属三峡医院2017年1月-2019年12月收治的90例HIV感染合并肺结核患者为合并HIV感染组,并选取100例单纯肺结核患者为对照组﹐比较两组患者胸部影像学特点,并分析合并HIV感染组患者外周血CD₄⁺T淋巴细胞和病毒载量水平与非典型结核表现的关系。结果两组患者的临床表现以咳嗽带痰,消瘦,夜间盗汗为主,且发生率无明显差异﹔胸部CT结果显示,合并HIV感染组病变部位可累及多肺叶,且无特定部位,对照组则以一叶病变为主,两组病灶范围比较有统计学差异(P<0.05);合并HIV感染组斑片阴影、片阴影、条索阴影、粟粒阴影﹑胸内淋巴结肿大、肺外结核等CT表现多于对照组﹐而结节阴影、斑点阴影、空洞、钙化等CT表现低于对照组﹐比较差异有统计学意义(P<0.05);CD₄⁺T淋巴细胞水平较低患者的斑片阴影﹑片阴影、粟粒阴影胸内淋巴结肿大、肺外结核等非典型CT结核表现率越高(P<0.05);病毒载量较高患者斑片阴影、片阴影、粟粒阴影、胸内淋巴结肿大、肺外结核等非典型CT结核表现率越高(P<0.05)。结论HIV感染合并肺结核患者的胸部CT表现不典型,并且非典型表现与外周血CD₄⁺T淋巴细胞降低和病毒载量升高有关。     

Aleutian Mink Disease Virus and Humans

Reports of a possible relationship between Aleutian mink disease parvovirus (AMDV) and human infection are rare. However, 2 mink farmers with vascular disease and microangiopathy similar to that in mink with Aleutian disease were found to have AMDV-specific antibodies and AMDV DNA. These findings raise the suspicion that AMDV may play a role in human disease.     

Novel Reassortant Avian Influenza A(H5N6) Virus,China, 2021

Although reports of human infection with influenza A(H5N6) increased in 2021, reports of similar H5N6 virus infection in poultry are few. We detected 10 avian influenza A(H5N6) clade 2.3.4.4b viruses in poultry from 4 provinces in China. The viruses showed strong immune-escape capacity and complex genetic reassortment, suggesting further transmission risk.     

Streptococcus suis Infection in Hospitalized Patients,Nakhon Phanom Province,Thailand

In Nakhon Phanom, Thailand, we identified 38 hospitalized patients with Streptococcus suis infection during 2006–2012. Deafness developed in 12 patients; none died. Thirty-five reported recent exposure to pigs/pork. Annual incidence was 0.1–2.2 cases/100,000 population (0.2–3.2 in persons >20 years of age). Clinicians should consider S. suis infection in areas where pig exposure is common.     

Zoonotic Onchocerca lupi Infection in Dogs,Greece and Portugal, 2011–2012

Onchocerca lupi infection is reported primarily in symptomatic dogs. We aimed to determine the infection in dogs from areas of Greece and Portugal with reported cases. Of 107 dogs, 9 (8%) were skin snip–positive for the parasite. DNA sequences of parasites in specimens from distinct dog populations differed genetically from thoses in GenBank.     

儿童慢性活动性EB病毒感染相关疾病谱及临床分析

[目的]了解小儿慢性EB病毒感染的临床表现及多系统损害情况,以提高临床诊治水平。[方法]对经临床确诊的15例慢性EB病毒感染患儿的临床表现、诊断及预后进行回顾性分析。[结果]显示临床表现多种多样,常出现严重或致死性的并发症,病例中有7例死亡,死亡率为46.7%,另有多例留下严重后遗症。[结论]慢性活动性EB病毒感染是一种预后不良的全身性感染,病死率较高,其中因脏器功能不全而死亡的病例约占半数,临床缺乏规范而有效的治疗方案。因此,输注自体EBV特异性细胞毒T淋巴细胞或异基因造血干细胞移植应有较好的治疗前景。     

Brucella ceti infection in harbor porpoise (Phocoena phocoena)

We describe Brucella sp. infection and associated lesions in a harbor porpoise (Phocoena phocoena) found on the coast of Belgium. The infection was diagnosed by immunohistochemistry, transmission electron microscopy, and bacteriology, and the organism was identified as B. ceti. The infection's location in the porpoise raises questions of abortion and zoonotic risks.     

Rigidoporus corticola Colonization and Invasive Fungal Disease in Immunocompromised Patients,United States

We report 2 cases of Rigidoporus corticola (Oxyporus corticola) infection in humans in the United States. Clinical manifestations consisted of angioinvasive fungal sinusitis in 1 patient and pulmonary intracavitary fungus ball in the other patient. These cases illustrate previously undescribed clinicopathologic manifestations of infection by this filamentous basidiomycete in humans.     

SARS-CoV-2 B.1.1.7 Variant Infection in Malayan Tigers,Virginia, USA

We report infection of 3 Malayan tigers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.7 (Alpha) variant at a zoologic park in Virginia, USA. All tigers exhibited respiratory signs consistent with SARS-CoV-2 infection. These findings show that tigers are susceptible to infection with the SARS-CoV-2 B.1.1.7 variant.     

Swine Influenza A(H3N2) Virus Infection in Immunocompromised Man,Italy, 2014

Because swine influenza virus infection is seldom diagnosed in humans, its frequency might be underestimated. We report a immunocompromised hematologic patient with swine influenza A(H3N2) virus in 2014 in Italy. Local pigs were the source of this human infection.     

Blastomycosis in man after kinkajou bite

We report transmission of Blastomyces dermatitidis fungal infection from a pet kinkajou to a man. When treating a patient with a recalcitrant infection and a history of an animal bite, early and complete animal necropsy and consideration of nonbacterial etiologies are needed.