® July 2008 Used with permission of Robert A. Adams A. Robert of permission with Used Central Nervous System Vol 14, No 7, July 2008 EMERGING INFECTIOUS DISEASES Pages 1013–1186 Peer-Reviewed Journal Tracking and Analyzing Disease Trends pages 1013–1186 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 David Brandling-Bennet, Washington, DC, USA Associate Editors Arturo Casadevall, New York, New York, USA Paul Arguin, Atlanta, Georgia, USA Kenneth C. Castro, Atlanta, Georgia, USA Charles Ben Beard, Ft. Collins, Colorado, USA Thomas Cleary, Houston, Texas, USA David Bell, Atlanta, Georgia, USA Anne DeGroot, Providence, Rhode Island, USA Charles H. Calisher, Ft. Collins, Colorado, USA Vincent Deubel, Shanghai, China Stephanie James, Bethesda, Maryland, USA Michael Drancourt, Marseille, France Paul V. Effl er, Honolulu, Hawaii, USA Ed Eitzen, Washington, DC, USA Nina Marano, Atlanta, Georgia, USA Duane J. Gubler, Honolulu, Hawaii, USA 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 Patrice Nordmann, Paris, France David L. Heymann, Geneva, Switzerland Marguerite Pappaioanou, Washington, DC, USA Daniel B. Jernigan, Atlanta, Georgia, USA Tanja Popovic, Atlanta, Georgia, USA Charles King, Cleveland, Ohio, USA Patricia M. Quinlisk, Des Moines, Iowa, USA Keith Klugman, Atlanta, Georgia, USA Jocelyn A. Rankin, Atlanta, Georgia, USA Takeshi Kurata, Tokyo, Japan Didier Raoult, Marseilles, France S.K. Lam, Kuala Lumpur, Malaysia Pierre Rollin, Atlanta, Georgia, USA Bruce R. Levin, Atlanta, Georgia, USA David Walker, Galveston, Texas, USA Myron Levine, Baltimore, Maryland, USA David Warnock, Atlanta, Georgia, USA Stuart Levy, Boston, Massachusetts, USA J. Todd Weber, Atlanta, Georgia, USA John S. MacKenzie, Perth, Australia Henrik C. Wegener, Copenhagen, Denmark Marian McDonald, Atlanta, Georgia, USA John E. McGowan, Jr., Atlanta, Georgia, USA Founding Editor K. Mills McNeill, Jackson, Mississippi, USA Joseph E. McDade, Rome, Georgia, USA Tom Marrie, Edmonton, Alberta, Canada Copy Editors Ban Mishu-Allos, Nashville, Tennessee, USA Thomas Gryczan, Anne Mather, Beverly Merritt, Philip P. Mortimer, London, United Kingdom Carol Snarey, P. Lynne Stockton, Cathy Young Fred A. Murphy, Galveston, Texas, USA Barbara E. Murray, Houston, Texas, USA Production P. Keith Murray, Geelong, Australia Reginald Tucker, Ann Jordan, Shannon O’Connor, Stephen M. Ostroff, Harrisburg, Pennsylvania, USA Carrie Huntington 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 David Relman, Palo Alto, California, USA Emerging Infectious Diseases Connie Schmaljohn, Frederick, Maryland, USA Emerging Infectious Diseases is published monthly by the Centers for Disease Tom Schwan, Hamilton, Montana, USA Control and Prevention, 1600 Clifton Road, Mailstop D61, Atlanta, GA 30333, Ira Schwartz, Valhalla, New York, USA USA. Telephone 404-639-1960, fax 404-639-1954, email [email protected]. 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 Dixie E. Snider, Atlanta, Georgia, USA institutions with which the authors are affi liated. 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Wilson, Cambridge, Massachusetts, USA ANSI/NISO 239.48-1992 (Permanence of Paper) Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 14, No. 7, July 2008 July 2008 On the Cover Toxinotype V Clostridium diffi cile Anne Adams (1940–2007) in Humans and Food Animals ...............1039 Pi (1998) M.A. Jhung et al. Gouache on paper. Such strains are uncommon causes of severe Used with permission human disease but may be increasing in incidence. of Robert A. Adams CME Activity Alcaligenes xylosoxidans About the Cover p. 1183 Bloodstream Infections in Outpatient Oncology Offi ce ...................1046 M.J. Kim et al. Gaps in infection control led to biofi lm production in central venous catheters and subsequent bloodstream infections. Testing for Coccidioidomycosis Perspective among Patients with Community- Acquired Pneumonia .............................. 1053 Spread of Vector-Borne D.C. Chang et al. Diseases and Neglect of Lack of testing may lead to underdiagnosis and Leishmaniasis, Europe .......................... 1013 underestimates of disease prevalence. J.-C. Dujardin et al. Exotic vector-borne diseases are gaining attention at Determinants of Cluster Size the expense of leishmaniasis. in Large, Population-Based Molecular Epidemiology Study Synopsis of Tuberculosis, Northern Malawi .........1060 Rickettsia felis as Emergent J.R. Glynn et al. Both epidemiologic and strain-related factors may Global Threat for Humans ..................... 1019 p. 1015 C.E. Pérez-Osorio et al. contribute to large clusters of TB patients. Incidence of human cases has increased as more public health authorities include it in differential Spotted Fever Group Rickettsiae diagnoses. in Ticks, Morocco ................................... 1067 M. Sarih et al. Identifi ed rickettsiae were 4 pathogens, 2 suspected Research pathogens, and 1 incompletely described species. Household Responses to School p. 1049 Closure Resulting from Outbreak of Transmission of Bartonella henselae Infl uenza B, North Carolina ................... 1024 by Ixodes ricinus .................................... 1074 A.J. Johnson et al. V. Cotté et al. Parents accepted school closure but children’s The causative agent of cat-scratch disease in presence in other public settings has implications for humans can be transmitted by this tick through pandemic planning. saliva. Attributable Outcomes of Characteristics of Dengue among Clostridium diffi cile–associated Ill Returned Travelers, 1997–2006 .........1081 Disease in Nonsurgical Patients ...........1031 E. Schwartz et al. E.R. Dubberke et al. Atypical patterns may indicate onset of endemic CDAD led to signifi cantly worse patient outcomes. activity. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 14, No. 7, July 2008 Etiology of Childhood Acute Bacterial Meningitis, Turkey ..................1089 M. Ceyhan et al. July 2008 Vaccines to prevent this disease in this region must 1154 Optimizing Use of Multistream Infl uenza protect against serogroup W-135. Sentinel Surveillance Data E.H.Y. Lau et al. Wide Distribution of High-Virulence Borrelia burgdorferi Clone in Europe and North America ................................. 1097 Another Dimension W.-G. Qiu et al. 1182 Husband We found substantial population differentiation and C.S. Watson recent trans-Atlantic dispersal of this strain. Letters Dispatches 1158 Mycobacterium bohemicum and Cervical Lymphadenitis in Children 1105 AIDS Patient Death Caused by Novel Cryptococcus neoformans × 1159 Pertussis Surveillance in Private Pediatric C. gattii Hybrid Practices, France, 2002–2006 M. Bovers et al. 1161 Avian Mycoplasma lipofaciens 1109 Swine Trichinella Infection and Transmission to Veterinarian Geographic Information System Tools 1163 Urinary Tract Infection Caused by R. Burke et al. Capnophilic Escherichia coli 1112 Unique Pattern of Enzootic Primate p. 1106 1164 Duck Migration and Infl uenza A (H5N1) Viruses in Gibraltar Macaques 1166 Dihydrofolate Reductase I164L Mutation G.A. Engel et al. in Plasmodium falciparum, Madagascar 1116 Pneumocystis jirovecii Transmission 1168 Bartonella quintana and Coxiella burnetii from Immunocompetent Carriers to Infant as Causes of Endocarditis, India L. Rivero et al. 1169 Acute Gastroenteritis Caused by GI/2 1119 Sudden Onset of Pseudotuberculosis in Sapovirus, Taiwan, 2007 Humans, France, 2004–05 1171 Importation of West Nile Virus from P. Vincent et al. Nicaraugua to Spain 1123 Molecular Typing of Trypanosoma cruzi 1173 Outbreak of Pertussis, Kabul, Afghanistan Isolates, United States 1175 Anthropogenic Infl uence on Prevalence D.M. Roellig et al. of 2 Amphibian Pathogens 1126 Profi ciency of Nucleic Acid Tests for 1176 Avian Infl uenza Virus (H5N1) Mortality Infl uenza Viruses, Australasia Surveillance S. Stelzer-Braid et al. 1178 Klebsiella pneumoniae Carbapenemase–2, 1129 New qnr Gene Cassettes in p. 1113 Buenos Aires, Argentina Vibrio cholerae O1 É.L. Fonseca et al. 1132 Experimental Infection of Cattle with