Peer-Reviewed Journal Tracking and Analyzing Disease Trends pages 365–518 EDITOR-IN-CHIEF D. Peter Drotman Managing Senior Editor EDITORIAL BOARD Polyxeni Potter, Atlanta, Georgia, USA Dennis Alexander, Addlestone Surrey, United Kingdom Senior Associate Editor Barry J. Beaty, Ft. Collins, Colorado, USA Brian W.J. Mahy, Atlanta, Georgia, USA Martin J. Blaser, New York, New York, USA Arturo Casadevall, New York, New York, USA Associate Editors Kenneth C. Castro, Atlanta, Georgia, USA Paul Arguin, Atlanta, Georgia, USA Thomas Cleary, Houston, Texas, USA Charles Ben Beard, Ft. Collins, Colorado, USA Anne DeGroot, Providence, Rhode Island, USA David Bell, Atlanta, Georgia, USA Vincent Deubel, Shanghai, China Charles H. Calisher, Ft. Collins, Colorado, USA Ed Eitzen, Washington, DC, USA Michael Drancourt, Marseille, France David Freedman, Birmingham, AL, USA Paul V. Effl er, Perth, Australia Kathleen Gensheimer, Augusta, ME, USA Nina Marano, Atlanta, Georgia, USA Peter Gerner-Smidt, Atlanta, GA USA Duane J. Gubler, Singapore Martin I. Meltzer, Atlanta, Georgia, USA Richard L. Guerrant, Charlottesville, Virginia, USA David Morens, Bethesda, Maryland, USA Scott Halstead, Arlington, Virginia, USA J. Glenn Morris, Gainesville, Florida, USA David L. Heymann, Geneva, Switzerland Patrice Nordmann, Paris, France Daniel B. Jernigan, Atlanta, Georgia, USA Tanja Popovic, Atlanta, Georgia, USA Charles King, Cleveland, Ohio, USA Jocelyn A. Rankin, Atlanta, Georgia, USA Keith Klugman, Atlanta, Georgia, USA Didier Raoult, Marseilles, France Takeshi Kurata, Tokyo, Japan Pierre Rollin, Atlanta, Georgia, USA S.K. Lam, Kuala Lumpur, Malaysia David Walker, Galveston, Texas, USA Bruce R. Levin, Atlanta, Georgia, USA David Warnock, Atlanta, Georgia, USA Myron Levine, Baltimore, Maryland, USA J. Todd Weber, Atlanta, Georgia, USA Stuart Levy, Boston, Massachusetts, USA Henrik C. Wegener, Copenhagen, Denmark John S. MacKenzie, Perth, Australia Marian McDonald, Atlanta, Georgia, USA Founding Editor John E. McGowan, Jr., Atlanta, Georgia, USA Joseph E. McDade, Rome, Georgia, USA K. Mills McNeill, Kampala, Uganda Copy Editors Tom Marrie, Edmonton, Alberta, Canada Karen Foster, Thomas Gryczan, Beverly Merritt, Rhonda Ray, Ban Mishu-Allos, Nashville, Tennessee, USA Philip P. Mortimer, London, United Kingdom Carol Snarey, P. Lynne Stockton Fred A. Murphy, Galveston, Texas, USA Production Barbara E. Murray, Houston, Texas, USA Ann Jordan, Shannon O’Connor, Carrie Huntington, Carole Liston, P. Keith Murray, Geelong, Australia Reginald Tucker Stephen M. Ostroff, Harrisburg, Pennsylvania, USA David H. Persing, Seattle, Washington, USA Editorial Assistant Richard Platt, Boston, Massachusetts, USA Susanne Justice Gabriel Rabinovich, Buenos Aires, Argentina Mario Raviglione, Geneva, Switzerland www.cdc.gov/eid Leslie Real, Atlanta, Georgia, USA Emerging Infectious Diseases David Relman, Palo Alto, California, USA Emerging Infectious Diseases is published monthly by the Centers for Disease Connie Schmaljohn, Frederick, Maryland, USA Control and Prevention, 1600 Clifton Road, Mailstop D61, Atlanta, GA 30333, Tom Schwan, Hamilton, Montana, USA USA. Telephone 404-639-1960, fax 404-639-1954, email [email protected]. Ira Schwartz, Valhalla, New York, USA Tom Shinnick, Atlanta, Georgia, USA The opinions expressed by authors contributing to this journal do not necessar- Bonnie Smoak, Bethesda, Maryland, USA ily refl ect the opinions of the Centers for Disease Control and Prevention or the institutions with which the authors are affi liated. Dixie E. 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Wilson, Cambridge, Massachusetts, USA Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 15, No. 3, March 2009 March 2009 On the Cover Coccidioidal Pneumonia, Liubov Popova (1889–1924) Phoenix, Arizona, USA, 2000–2004 .........397 The Traveler (1915) M.M. Kim et al. Oil on canvas (142.2 cm × 105.4 cm) A prospective evaluation identifi ed Coccidioides Courtesy of Norton Simon Art Foundation, spp. as frequent causes of community-acquired Pasadena, CA, USA pneumonia. Characterization of Avian Infl uenza Viruses A (H5N1) from About the Cover p. 513 Wild Birds, Hong Kong, 2004–2008 ........ 402 G.J.D. Smith et al. Repeated detection of subclade 2.3.2 viruses in nonpasserine birds from different regions suggests establishment of this lineage in wild bird species. Perspective Infl uenza-like Illness in Children, Meeting the Challenge of Nicaragua, 2005–2007 ..............................408 Infl uenza Pandemic Preparedness A. Gordon et al. in Developing Countries ..........................365 Case rates were high and had marked seasonal D.S. Fedson peaks. These countries should consider using inexpensive generic agents to confront the next pandemic. CME ACTIVITY Clinical Risk Factors for Severe Research Clostridium diffi cile–associated Disease ...................................................... 415 Shiga Toxin–producing Escherichia T.J. Henrich et al. coli Strains Negative for Locus of Rapidly available information, such as age and Enterocyte Effacement............................. 372 p. 374 laboratory and radiologic data, can be used to H.J. Newton et al. identify adverse outcomes. The Ehx plasmids of these strains are highly related, which suggests acquisition of the large plasmid was Capacity of Thailand to Contain an central to the strains’ emergence. Emerging Infl uenza Pandemic ................ 423 W. Putthasri et al. Sources of Hepatitis E Virus In a severe pandemic, resource gaps are likely to be Genotype 3 in the Netherlands................ 381 profound. S.A. Rutjes et al. Four subtypes have been detected, and p. 393 pathogenicity, zoonotic potential, or stability may Dispatches vary between subtypes. 433 Epidemiology of Bluetongue Virus Integron-mediated Multidrug Resistance Serotype 8, Germany in a Global Collection of Nontyphoidal F.J. Conraths et al. Salmonella enterica Isolates ................... 388 436 Evaluation of Anti–Dengue Virus M.G. Krauland et al. Immunoglobulin M Tests Horizontal gene transfer and clonal expansion E.A. Hunsperger et al. contribute substantially to the dissemination of 441 Astrovirus MLB1 in Stool Samples resistant strains. from Children S.R. Finkbeiner et al. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 15, No. 3, March 2009 445 Introduction into Nigeria of a Distinct Genotype of Avian Infl uenza Virus (H5N1) March 2009 A. Fusaro et al. 448 Border Disease Virus among Letters Chamois, Spain 495 Guillain-Barré Syndrome after I. Marco et al. Chikungunya Infection 452 Methicillin-Resistant Staphylococcus 496 Cockroaches (Ectobius vittiiventris) aureus in Poultry in an Intensive Care Unit, Switzerland D. Persoons et al. 497 Cutaneous Anthrax, West Bengal, 454 Human Bocavirus and KI/WU India, 2007 Polyomaviruses in Pediatric 499 Cat-to-Human Orthopoxvirus Intensive Care Patients Transmission, Northeastern Italy A.C. van de Pol et al. 501 Pertussis in Afghanistan, 2007–2008 S2-12 458 Rocky Mountain Spotted Fever in ture; N, owl; P, owl and heron; A, eagle; F, herons J, peafowls; Q, owls; D, owls; F, owls 502 Salmonella bongori in Migratory Dogs, Brazil NA, heron, egrets, ducks, mynahs, starlings, doves pigeons, jungle fowls; H, guinea fowl, parakeets M.B. Labruna et al. Birds, Italy – 1 Walk-through exhibit SECTION 1 tbid d ) 503 Comet Sign (and Other) in Pyemotes 461 Crimean-Congo Hemorrhagic Fever p. 475 Virus in High-Risk Population, Turkey Dermatitis T. Gunes et al. 504 Helicobacter pylori in Patients 465 Sudden Increase in Listeriosis Rates Undergoing Upper Endoscopy, in England and Wales, 2001 and 2003 Georgia B.J. Cairns and R.J.H. Payne 506 Spelling Pneumocystis jirovecii 469 Coordinated Implementation 506 Hypothetical Pneumocystis of Chikungunya Virus Reverse jirovecii Transmission from Transcription–PCR Immunocompetent Carriers to Infant M. Panning et al. (response) 472 Extended-Spectrum β-Lactamase– 508 Delinquent Mortgages, Neglected Producing Enterobacteriaceae in Swimming Pools, and West Nile Malian Orphanage Virus, California (response) D. Tandé et al. 475 Highly Pathogenic Avian Infl uenza p. 503 Virus (H5N1) Outbreak in Captive Book Reviews Wild Birds and Cats, Cambodia 510 Avian Infl uenza S. Desvaux et al. 510 Forgotten People, Forgotten 479 Hepatitis E Virus Antibodies in Diseases Patients with Chronic Liver Disease 511 Travel Medicine, 2nd Edition M. Atiq et al. 482 Detection of Novel SARS-like and Other Coronaviruses in Bats from Another Dimension Kenya 512 Fantastic Voyage: Infl uenza S. Tong et al. J.W. Tang 486 Rickettsia spp. in Ticks, Poland T. Chmielewski et al. News and Notes 489 Merkel Cell Polyomavirus in Respiratory Tract Secretions About the Cover S. Goh et al. 513 Tango with Cows 492 Merkel Cell Polyomavirus DNA in Respiratory