® February 2020 Purchase and partial gift from the Catherine and Ralph Benkaim Collection; Severance and Greta Millikin Purchase Fund. Public domain digital image courtesy of The Cleveland Museum of Modern Art, Cleveland, Ohio Cleveland, Art, Modern of Museum Cleveland The of courtesy image digital domain Public Fund. Purchase Millikin Greta and Severance Collection; Benkaim Ralph and Catherine the from gift partial and Purchase Opaque watercolor, ink, and gold on paper. 10 1/4 in x 6 15/16 in/26 cm x 17.6 cm. cm. 17.6 x cm in/26 15/16 6 x in 1/4 10 paper. on gold and ink, watercolor, Opaque , Possibly Maru Ragini from a Ragamala, 1650–80. 1650–80. Ragamala, a from Ragini Maru Possibly , A Rajput Warrior with Camel with Warrior Rajput A Artist Unknown. Unknown. Artist Coronaviruses Vol 26, No 2, February 2020 EMERGING INFECTIOUS DISEASES Pages 191–400 DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention (CDC) Mailstop D61, Atlanta, GA 30329-4027 Official Business Penalty for Private Use $300 Return Service Requested ISSN 1080-6040 Peer-Reviewed Journal Tracking and Analyzing Disease Trends Pages 191–400 EDITOR-IN-CHIEF D. Peter Drotman ASSOCIATE EDITORS EDITORIAL BOARD Charles Ben Beard, Fort Collins, Colorado, USA Barry J. Beaty, Fort Collins, Colorado, USA Ermias Belay, Atlanta, Georgia, USA Martin J. Blaser, New York, New York, USA David M. Bell, Atlanta, Georgia, USA Andrea Boggild, Toronto, Ontario, Canada Sharon Bloom, Atlanta, Georgia, USA Christopher Braden, Atlanta, Georgia, USA Richard Bradbury, Melbourne, Australia Arturo Casadevall, New York, New York, USA Mary Brandt, Atlanta, Georgia, USA Kenneth G. Castro, Atlanta, Georgia, USA Corrie Brown, Athens, Georgia, USA Vincent Deubel, Shanghai, China Charles H. Calisher, Fort Collins, Colorado, USA Christian Drosten, Charité Berlin, Germany Benjamin J. Cowling, Hong Kong, China Isaac Chun-Hai Fung, Statesboro, Georgia, USA Michel Drancourt, Marseille, France Kathleen Gensheimer, College Park, Maryland, USA Paul V. Effler, Perth, Australia Anthony Fiore, Atlanta, Georgia, USA Rachel Gorwitz, Atlanta, Georgia, USA David O. Freedman, Birmingham, Alabama, USA Duane J. Gubler, Singapore Peter Gerner-Smidt, Atlanta, Georgia, USA Richard L. Guerrant, Charlottesville, Virginia, USA Stephen Hadler, Atlanta, Georgia, USA Scott Halstead, Arlington, Virginia, USA Matthew J. Kuehnert, Edison, New Jersey, USA David L. Heymann, London, UK Nina Marano, Atlanta, Georgia, USA Keith Klugman, Seattle, Washington, USA Martin I. Meltzer, Atlanta, Georgia, USA Takeshi Kurata, Tokyo, Japan David Morens, Bethesda, Maryland, USA S.K. Lam, Kuala Lumpur, Malaysia J. Glenn Morris, Jr., Gainesville, Florida, USA Stuart Levy, Boston, Massachusetts, USA Patrice Nordmann, Fribourg, Switzerland John S. Mackenzie, Perth, Australia Johann D.D. Pitout, Calgary, Alberta, Canada John E. McGowan, Jr., Atlanta, Georgia, USA Ann Powers, Fort Collins, Colorado, USA Jennifer H. McQuiston, Atlanta, Georgia, USA Didier Raoult, Marseille, France Tom Marrie, Halifax, Nova Scotia, Canada Pierre E. Rollin, Atlanta, Georgia, USA Nkuchia M. M’ikanatha, Harrisburg, Pennsylvania, USA Frederic E. Shaw, Atlanta, Georgia, USA David H. Walker, Galveston, Texas, USA Frederick A. Murphy, Bethesda, Maryland, USA J. Todd Weber, Atlanta, Georgia, USA Barbara E. Murray, Houston, Texas, USA J. Scott Weese, Guelph, Ontario, Canada Stephen M. Ostroff, Silver Spring, Maryland, USA Mario Raviglione, Milan, Italy, and Geneva, Switzerland Managing Editor Byron Breedlove, Atlanta, Georgia, USA David Relman, Palo Alto, California, USA Guenael R. 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Joseph E. McDade, Rome, Georgia, USA Telephone 404-639-1960, fax 404-639-1954, email [email protected]. The conclusions, findings, and opinions expressed by authors All material published in Emerging Infectious Diseases is in the contributing to this journal do not necessarily reflect the official public domain and may be used and reprinted without special position of the U.S. Department of Health and Human Services, permission; proper citation, however, is required. the Public Health Service, the Centers for Disease Control and Use of trade names is for identification only and does not imply Prevention, or the authors’ affiliated institutions. Use of trade names endorsement by the Public Health Service or by the U.S. Department is for identification only and does not imply endorsement by any of of Health and Human Services. the groups named above. EMERGING INFECTIOUS DISEASES is a registered service mark of the U.S. Department of Health & Human Services (HHS). Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 26, No. 2, February 2020 Coronaviruses February 2020 Synopses Acute Toxoplasmosis among Canadian Deer Hunters Associated with Consumption of Undercooked Deer Meat Hunted in the United States Heath professionals should be aware that such outbreaks might be more common in the future. C. Gaulin et al. 199 Public Health Program for Decreasing Risk for Ebola Virus Disease Resurgence from Survivors of the 2013–2016 Outbreak, Guinea M. Keita et al. 206 Research Characteristics of Patients with Acute Flaccid Myelitis, United States, 2015–2018 Differences in clinical and laboratory characteristics between years with and without increased activity suggest differences in viral etiologies. N. McLaren et al. 212 On the Cover Illness Severity in Hospitalized Influenza Patients by Virus Type and Subtype, Spain, 2010–2017 Artist Unknown. A Rajput Warrior with Camel, possibly Maru Ragini from a Ragamala, 1650–80. Opaque watercolor, ink, and gold on paper. Influenza A(H1N1)pdm09 infections caused more 10 1/4 in x 6 15/16 in/26 cm x 17.6 cm. Purchase and partial gift from the hospitalizations, intensive care unit admissions, and Catherine and Ralph Benkaim Collection; Severance and Greta Millikin deaths than influenza A(H3N2) or B infections. Purchase Fund. Public domain digital image courtesy of The Cleveland Museum of Modern Art, Cleveland, Ohio C. Delgado-Sanz et al. 220 About the Cover p. 395 Exposure to Ebola Virus and Risk for Infection with Malaria Parasites, Rural Gabon Perspective J.L. Abbate et al. 229 Middle East Respiratory Syndrome Cost-Effectiveness of Screening Program for Coronavirus Transmission Chronic Q Fever, the Netherlands M.E. Killerby et al. 191 P.T. de Boer et al. 238 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 26, No. 2, February 2020 February 2020 Elizabethkingia anopheles Infection in Infants, Cambodia, 2012–2018 T.A.N. Reed et al. 320 Global Expansion of Pacific NorthwestVibrio parahaemolyticus Sequence Type 36 M. Abanto et al. 323 Surge in Anaplasmosis Cases in Maine, USA, 277 2013–2017 S.P. Elias et al. 327 Unique Clindamycin-Resistant Clostridioides Mycoplasma genitalium Antimicrobial difficile Strain Related to Fluoroquinolone- Resistance in Community and Sexual Health Resistant Epidemic BI/RT027 Strain Clinic Patients, Auckland, New Zealand A.M. Skinner et al. 247 A. Vesty et al. 332 Porcine Deltacoronavirus Infection and Early Detection of Public Health Emergencies Transmission in Poultry, United States of International Concern through Undiagnosed P.A. Boley et al. 255 Disease Reports in ProMED-Mail C. Rolland et al. 336 Chronic Human Pegivirus 2 and Hepatitis C Virus Co-infection Ocular Spiroplasma ixodetis in Newborns, France K.E. Coller et al. 265 A. Matet et al. 340 Interspecies Transmission of Reassortant Swine Influenza A Virus Containing Genes from Swine Influenza A(H1N1)pdm09 and A(H1N2) Viruses H.E. Everett et al. 273 Multiplex Mediator Displacement Loop-Mediated Isothermal Amplification for Detection of Treponema pallidum and Haemophilus ducreyi L. Becherer et al. 282 Novel Subclone of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 with Enhanced Virulence and Transmissibility, China K. Zhou et al. 289 Neutralizing Antibodies against Enteroviruses in Patients with Hand, Foot and Mouth Disease L.A. Nguyet et al. 298 Dispatches Emergence of Chikungunya Virus, Pakistan, 2016–2017 N. Badar et al. 307 Influence of Rainfall on Leptospira Infection and Disease in a Tropical Urban Setting, Brazil K.P. Hacker et al. 311 Systematic Hospital-Based Travel Screening to Assess Exposure to Zika Virus A. Iqbal et al. 315 365 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 26, No. 2, February 2020 Use of Surveillance Outbreak Response Management and Analysis System for Human Monkeypox Outbreak, Nigeria, 2017–2019 B.C. Silenou et al. 345 Human Norovirus Infection in Dogs, Thailand K. Charoenkul et al. 350 February 2020 Hepatitis