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A Peer-Reviewed Journal Tracking and Analyzing Disease Trends pages 369–542 EDITOR-IN-CHIEF D. Peter Drotman EDITORIAL STAFF EDITORIAL BOARD Founding Editor Dennis Alexander, Addlestone Surrey, United Kingdom Joseph E. McDade, Rome, Georgia, USA Ban Allos, Nashville, Tennessee, USA Managing Senior Editor Michael Apicella, Iowa City, Iowa, USA Paul Arguin, Atlanta, Georgia, USA Polyxeni Potter, Atlanta, Georgia, USA Barry J. Beaty, Ft. Collins, Colorado, USA Associate Editors Martin J. Blaser, New York, New York, USA Charles Ben Beard, Ft. Collins, Colorado, USA David Brandling-Bennet, Washington, D.C., USA David Bell, Atlanta, Georgia, USA Donald S. Burke, Baltimore, Maryland, USA Jay C. Butler, Anchorage, Alaska, USA Arturo Casadevall, New York, New York, USA Charles H. Calisher, Ft. Collins, Colorado, USA Kenneth C. Castro, Atlanta, Georgia, USA Stephanie James, Bethesda, Maryland, USA Thomas Cleary, Houston, Texas, USA Anne DeGroot, Providence, Rhode Island, USA Brian W.J. Mahy, Atlanta, Georgia, USA Vincent Deubel, Shanghai, China Martin I. Meltzer, Atlanta, Georgia, USA Ed Eitzen, Washington, D.C., USA David Morens, Bethesda, Maryland, USA Duane J. Gubler, Honolulu, Hawaii, USA J. Glenn Morris, Baltimore, Maryland, USA Richard L. Guerrant, Charlottesville, Virginia, USA Nina Marano, Atlanta, Georgia, USA Scott Halstead, Arlington, Virginia, USA Marguerite Pappaioanou, St. Paul, Minnesota, USA David L. Heymann, Geneva, Switzerland Tanja Popovic, Atlanta, Georgia, USA Sakae Inouye, Tokyo, Japan Charles King, Cleveland, Ohio, USA Patricia M. Quinlisk, Des Moines, Iowa, USA Keith Klugman, Atlanta, Georgia, USA Gabriel Rabinovich, Buenos Aires, Argentina Takeshi Kurata, Tokyo, Japan Jocelyn A. Rankin, Atlanta, Georgia, USA S.K. Lam, Kuala Lumpur, Malaysia Didier Raoult, Marseilles, France Bruce R. Levin, Atlanta, Georgia, USA Pierre Rollin, Atlanta, Georgia, USA Myron Levine, Baltimore, Maryland, USA David Walker, Galveston, Texas, USA Stuart Levy, Boston, Massachusetts, USA J. Todd Weber, Atlanta, Georgia, USA John S. MacKenzie, Perth, Australia Tom Marrie, Edmonton, Alberta, Canada Henrik C. Wegener, Copenhagen, Denmark John E. McGowan, Jr., Atlanta, Georgia, USA Copy Editors Philip P. Mortimer, London, United Kingdom Angie Frey, Thomas Gryczan, Ronnie Henry, Fred A. Murphy, Galveston, Texas, USA Anne Mather, Carol Snarey Barbara E. Murray, Houston, Texas, USA Production P. Keith Murray, Ames, Iowa, USA Reginald Tucker, Ann Jordan, Maureen Marshall Stephen Ostroff, Honolulu, Hawaii, USA Editorial Assistant Rosanna W. Peeling, Geneva, Switzerland David H. Persing, Seattle, Washington, USA Susanne Justice Richard Platt, Boston, Massachusetts, USA www.cdc.gov/eid Mario Raviglione, Geneva, Switzerland Leslie Real, Atlanta, Georgia, USA Emerging Infectious Diseases David Relman, Palo Alto, California, USA Emerging Infectious Diseases is published monthly by the Nancy Rosenstein, Atlanta, Georgia, USA National Center for Infectious Diseases, Centers for Disease Connie Schmaljohn, Frederick, Maryland, USA Control and Prevention, 1600 Clifton Road, Mailstop D61, Tom Schwan, Hamilton, Montana, USA Atlanta, GA 30333, USA. Telephone 404-639-1960, Ira Schwartz, Valhalla, New York, USA fax 404-639-1954, email [email protected]. Tom Shinnick, Atlanta, Georgia, USA Bonnie Smoak, Bethesda, Maryland, USA The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the Centers for Disease Rosemary Soave, New York, New York, USA Control and Prevention or the institutions with which the authors P. Frederick Sparling, Chapel Hill, North Carolina, USA are affiliated. Jan Svoboda, Prague, Czech Republic Bala Swaminathan, Atlanta, Georgia, USA All material published in Emerging Infectious Diseases is in Robert Swanepoel, Johannesburg, South Africa the public domain and may be used and reprinted without special Phillip Tarr, St. Louis, Missouri, USA permission; proper citation, however, is required. Timothy Tucker, Cape Town, South Africa Use of trade names is for identification only and does not Elaine Tuomanen, Memphis, Tennessee, USA imply endorsement by the Public Health Service or by the U.S. John Ward, Atlanta, Georgia, USA Department of Health and Human Services. David Warnock, Atlanta, Georgia, USA ∞ Emerging Infectious Diseases is printed on acid-free paper that meets Mary E. Wilson, Cambridge, Massachusetts, USA the requirements of ANSI/NISO 239.48-1992 (Permanence of Paper) Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 12, No. 3, March 2006 March 2006 On the Cover Aspergillus ustus Infections Rembrandt van Rijn (1606–1669). among Transplant Recipients . .403 Scholar in His Study (1634). A.A. Panackal et al. Oil on canvas (141 cm × 135 cm). This is the first report of clustered A. ustus causing National Gallery in Prague, Czech Republic. systemic disease in transplant patients. Clostridium difficile Infections, About the Cover p. 537 US Hospitals, 1996–2003 . .409 L.C. McDonald et al. Clinicians should be aware of the increasing risk for C. difficile–associated disease and make efforts to control its transmission. Medication Sales and p. 370 Syndromic Surveillance . .416 E. Vergu et al. Real-time over-the-counter drug sales provide an Perspectives additional tool for disease surveillance. Possibilities for Relapsing Fever Reemergence . .369 Personal Hygiene and S.J. Cutler MRSA Infection . .422 Increasing globalization may pave the way for G. Turabelidze et al. reemergence of relapsing fever. Improving personal hygiene practices may prevent and control MRSA outbreaks. Cost-effectiveness of West Nile Virus Vaccination . .375 Rapid Detection of A. Zohrabian et al. Rickettsia prowazekii . .428 Universal vaccination is unlikely to result in societal S. Svraka et al. monetary savings. This highly standardized and adaptable assay could improve epidemic typhus surveillance. Synopses Serosurvey on Household Web-based Surveillance Contacts of Marburg Patients . .433 and Salmonella Distribution . .381 M. Borchert et al. E. Galanis et al. Asymptomatic secondary infections are rare. Surveillance improves control of Salmonella infections. Canine Visceral Leishmaniasis, 2000–2003 . .440 Bartonella in Pets Z.H. Duprey et al. and Human Health . .389 Foxhounds infected with Leishmania spp. were B.B. Chomel et al. found in 18 states and 2 Canadian provinces. Pets represent a large reservoir for human infection. Chemoprophylaxis and Malaria Death Rates . .447 Research G. Krause et al. West Nile Virus Infections, Malaria chemoprophylaxis increases the survival of United States, 2003 . .395 nonimmune travelers. M.P. Busch et al. p. 463 Routine donor nucleic acid amplification testing is a valuable surveillance screening tool. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 12, No. 3, March 2006 Self-medication with Antimicrobial Drugs in Europe . .452 L. Grigoryan et al. March 2006 Antimicrobial drug self-medication occurs most often in eastern and southern Europe and least often in northern and western Europe. 511 Protease-resistant Prion Protein in Mice Pneumonic Plague Cluster, L. Cervenakova et al. Uganda, 2004 . .460 E.M. Begier et al. 514 West Nile Virus Paralysis Outcome In a case cluster, pneumonic plague transmission J.J. Sejvar et al. was compatible with respiratory droplet rather than aerosol transmission. Letters Mosquitoes and West Nile Virus Transmission . .468 517 Human Pythiosis G. Molaei et al. 518 Rift Valley Fever Potential, Arabian Culex salinarius is a bridge vector to humans, while Peninsula Cx. pipiens and Cx. restuans are more efficient enzootic vectors. 520 Screening and Toxigenic Corynebacteria Spread Genotypes in Polyclonal Infections 521 Rickettsia slovaca Infection, by Single Species . .475 France J.M. Colborn et al. The combination of real-time PCR and capillary p. 487 523 Cutaneous Anthrax, Belgian electrophoresis permits the rapid identification and Traveler quantification of pathogen genotypes. 525 Japanese Encephalitis, Singapore Dispatches 526 HIV and Lacaziosis, Brazil 527 Hand Sanitizer Alert 483 “Candidatus Rickettsia kellyi,” 529 Spleen Abscess as Malaria India Complication J.M. Rolain et al. 531 Rickettsioses in South Korea, 486 Lyssavirus Surveillance in Bats, Materials and Methods Bangladesh I.V. Kuzmin et al. 531 Rickettsioses in South Korea, 489 Resistant Salmonella Paratyphi A Data Analysis Isolate, India 532 “Mycobacterium tilburgii” S. Nair et al. p. 524 Infections 492 Highly Pathogenic Canine Coronavirus C. Buonavoglia et al. Book Reviews 495 Acute Hemorrhagic Conjunctivitis, 535 Infection and Autoimmunity Rio de Janeiro F.N. Tavares et al. 535 World Class Parasites: Vol. X, Schistosomiasis 498 Pneumonia and New MRSA Clone F. Garnier et al. 501 Canine Leptospirosis News & Notes G.E. Moore et al. 504 Lagos Bat Virus, South Africa About the Cover W. Markotter et al. 537 Different Strokes for Different Folks in Search of Truth 507 Salmonella Paratyphi B in Aquariums R.S. Levings et al. Notice to Readers and Contributing Authors Summaries of emerging infectious disease conferences are published online only. Summaries submitted for online publication may include illustrations and relevant links. For more information on conference summary requirements, please refer to author guidelines at http://www.cdc.gov/ncidod/eid/instruct.htm. Submit conference summaries at http://www.eid.manuscriptcentral.com Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 12, No. 3, March 2006 Possibilities for Relapsing Fever Reemergence Sally J. Cutler* Relapsing fever Borrelia