Peer-Reviewed Journal Tracking and Analyzing Disease Trends pages 1789-1968 EDITOR-IN-CHIEF D. Peter Drotman Associate Editors EDITORIAL BOARD Paul Arguin, Atlanta, Georgia, USA Dennis Alexander, Addlestone, Surrey, UK Charles Ben Beard, Ft. Collins, Colorado, USA Timothy Barrett, Atlanta, Georgia, USA Ermias Belay, Atlanta, Georgia, USA Barry J. Beaty, Ft. Collins, Colorado, USA David Bell, Atlanta, Georgia, USA Martin J. Blaser, New York, New York, USA Sharon Bloom, Atlanta, GA, USA Christopher Braden, Atlanta, Georgia, USA Mary Brandt, Atlanta, Georgia, USA Arturo Casadevall, New York, New York, USA Corrie Brown, Athens, Georgia, USA Kenneth C. Castro, Atlanta, Georgia, USA Charles H. Calisher, Ft. Collins, Colorado, USA Louisa Chapman, Atlanta, Georgia, USA Michel Drancourt, Marseille, France Thomas Cleary, Houston, Texas, USA Paul V. Effler, Perth, Australia Vincent Deubel, Shanghai, China David Freedman, Birmingham, Alabama, USA Ed Eitzen, Washington, DC, USA Peter Gerner-Smidt, Atlanta, Georgia, USA Daniel Feikin, Baltimore, Maryland, USA Stephen Hadler, Atlanta, Georgia, USA Anthony Fiore, Atlanta, Georgia, USA Nina Marano, Nairobi, Kenya Kathleen Gensheimer, College Park, MD, USA Martin I. Meltzer, Atlanta, Georgia, USA Duane J. Gubler, Singapore David Morens, Bethesda, Maryland, USA Richard L. Guerrant, Charlottesville, Virginia, USA J. Glenn Morris, Gainesville, Florida, USA Scott Halstead, Arlington, Virginia, USA Patrice Nordmann, Fribourg, Switzerland Katrina Hedberg, Portland, Oregon, USA Tanja Popovic, Atlanta, Georgia, USA David L. Heymann, London, UK Didier Raoult, Marseille, France Charles King, Cleveland, Ohio, USA Pierre Rollin, Atlanta, Georgia, USA Keith Klugman, Seattle, Washington, USA Ronald M. Rosenberg, Fort Collins, Colorado, USA Takeshi Kurata, Tokyo, Japan Frank Sorvillo, Los Angeles, California, USA S.K. Lam, Kuala Lumpur, Malaysia David Walker, Galveston, Texas, USA Stuart Levy, Boston, Massachusetts, USA Senior Associate Editor, Emeritus John S. MacKenzie, Perth, Australia Brian W.J. Mahy, Bury St. Edmunds, Suffolk, UK Marian McDonald, Atlanta, Georgia, USA John E. McGowan, Jr., Atlanta, Georgia, USA Acting Managing Editor Jennifer H. McQuiston, Atlanta, Georgia, USA Byron Breedlove, Atlanta, Georgia, USA Tom Marrie, Halifax, Nova Scotia, Canada Philip P. Mortimer, London, UK Copy Editors Claudia Chesley, Karen Foster, Thomas Gryczan, Jean Michaels Jones, Shannon O’Connor, Carol Snarey, Fred A. Murphy, Galveston, Texas, USA P. Lynne Stockton Barbara E. Murray, Houston, Texas, USA P. Keith Murray, Geelong, Australia Production William Hale, Barbara Segal, Reginald Tucker Stephen M. Ostroff, Silver Spring, MD, USA Gabriel Rabinovich, Buenos Aires, Argentina Editorial Assistant Jared Friedberg Mario Raviglione, Geneva, Switzerland Communications/Social Media Sarah Logan Gregory David Relman, Palo Alto, California, USA Connie Schmaljohn, Frederick, Maryland, USA Founding Editor Tom Schwan, Hamilton, Montana, USA Joseph E. McDade, Rome, Georgia, USA Ira Schwartz, Valhalla, New York, USA Emerging Infectious Diseases is published monthly by the Centers for Tom Shinnick, Atlanta, Georgia, USA Disease Control and Prevention, 1600 Clifton Road, Mailstop D61, Atlan- Bonnie Smoak, Bethesda, Maryland, USA ta, GA 30333, USA. Telephone 404-639-1960, fax 404-639-1954, email Rosemary Soave, New York, New York, USA [email protected]. P. Frederick Sparling, Chapel Hill, North Carolina, USA Robert Swanepoel, Pretoria, South Africa Phillip Tarr, St. Louis, Missouri, USA The opinions expressed by authors contributing to this journal do not Timothy Tucker, Cape Town, South Africa necessarily reflect the opinions of the Centers for Disease Control and Prevention or the institutions with which the authors are affiliated. Elaine Tuomanen, Memphis, Tennessee, USA All material published in Emerging Infectious Diseases is in the public John Ward, Atlanta, Georgia, USA domain and may be used and reprinted without special permission; proper J. Todd Weber, Atlanta, Georgia, USA citation, however, is required. Mary E. Wilson, Cambridge, Massachusetts, USA Use of trade names is for identification only and does not imply endorsement by the Public Health Service or by the U.S. Department of Health ∞ Emerging Infectious Diseases is printed on acid-free paper that meets the requirements and Human Services. of ANSI/NISO 239.48-1992 (Permanence of Paper) Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 20, No. 11, November 2014 November 2014 On the Cover Genomic Definition of Hypervirulent and Multidrug-Resistant Klebsiella Paul Cézanne 1839–1906 Still Life with Apples 1893–1894 pneumoniae Clonal Groups ............. 1812 Oil on canvas S. Bialek-Davenet et al. 65.4 × 81.6 cm (25 3/4 × 32 1/8 in.) A web-accessible genome database enables rapid extraction of genotype, virulence, and The J. Paul Getty Museum resistance information from sequences. Digital image courtesy of the J. Paul Getty Museum Open Content Program. Respiratory Viruses and About the Cover p. 1962 Bacteria among Pilgrims during Synopses the 2013 Hajj...................................... 1821 S. Benkouiten et al. The most common pathogens detected were coronavirus, rhinovirus, influenza virus, and Streptococcus pneumoniae. Blastomycosis Mortality Rates, United States, Seroprevalence of Norovirus 1990–2010 .......................... 1789 Genogroup IV Antibodies among D. Khuu et al. Humans, Italy, 2010–2011 ................. 1828 Blastomycosis, an underdiagnosed B. Di Martino et al. airborne fungal disease, caused Antibodies specific to genogroup IV identified in 1,216 documented deaths. human specimens suggest zoonotic exposure. Drug-Resistant Candida glabrata p. 1806 Infection in Cancer Patients ............ 1833 Legionnaires’ Disease D. Farmakiotis et al. Incidence and Risk Factors, High rates of resistance to azoles and New York, New York, USA, echinocandins emphasize the need for good 2002–2011 .......................... 1795 stewardship of antifungal drugs. A. Farnham et al. Living in low-income areas and Novel Chlamydia trachomatis Strains working in certain occupations may in Heterosexual Sex Partners, increase risk. Indianapolis, Indiana, USA .............. 1841 p. 1816 B.E. Batteiger et al. Research Use of multilocus sequence typing may help improve identification of new strains among Death Patterns during the 1918 at-risk populations. Influenza Pandemic in Chile ............ 1803 Spread of Streptococcus pneumoniae G. Chowell et al. Serotype 8-ST63 Multidrug-Resistant Death rates varied by region but not age group Recombinant Clone, Spain .............. 1848 and peaked during July–August 1919. C. Ardanuy et al. This clone has spread throughout this country and caused invasive pneumococcal disease. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 20, No. 11, November 2014 Foodborne Illness, Australia, Circa 2000 and Circa 2010 ......................... 1857 M. Kirk et al. November 2014 Overall incidence of foodborne gastroenteritis 1899 Beijing Lineage of MDR declined but remains high, and the incidence Mycobacterium tuberculosis in of salmonellosis and campylobacteriosis increased. Bulgaria, 2007–2011 S. Panaiotov et al. Sequelae of Foodborne Illness Caused by 5 Pathogens, Australia, 1902 Human InfluenzaA(H7N9) Virus Circa 2010.......................................... 1865 Infection Associated with Poultry L. Ford et al. Farm, Northeastern China Foodborne gastroenteritis results in a M. Fan et al. substantial amount of severe and disabling sequelae. 1906 Detection of Rare G3P[19] Group A Rotavirus in Human Dispatches Patient, Italy p. 1877 G. Ianiro et al. 1872 Increasing Prevalence and Intensity of Foodborne 1911 New Parvovirus in Child with Clonorchiasis, Hengxian County, Unexplained Diarrhea, Tunisia China, 1989–2011 T.G. Phan et al. M.-B. Qian et al. 1914 Hepatitis E Virus Infections in 1876 Mycobacterium ulcerans Blood Donors, France Infection Imported from Australia P. Gallian et al. to Missouri, USA, 2012 B.S. Thomas et al. 1918 ESBL-producing Salmonella enterica Serovar Typhi in 1880 Severe Fever with Traveler Returning from Thrombocytopenia Syndrome p. 1884 Guatemala to Spain Virus, South Korea, 2013 J.J. González-López et al. S.-W. Park et al. 1921 Nosocomial Neonatal 1883 Human Herpes Simplex Virus Legionellosis Associated with Type 1 in Confiscated Gorilla Water in Infant Formula, Taiwan K.V.K. Gilardi et al. S.-H. Wei et al. 1887 Vaccine-Induced Waning 1925 Frequent Hepatitis E Virus of Haemophilus influenzae Contamination in Food Empyema and Meningitis, Containing Raw Pork Liver, Angola France H. Peltola et al. N. Pavio et al. 1891 Poultry Market Closures and 1928 Global Incidence of Human Infection with Influenza Carbapenemase-Producing A(H7N9) Virus, China, 2013–14 Escherichia coli ST131 P. Wu et al. G. Peirano et al. 1895 Raw Pig Blood Consumption and Potential Risk for Streptococcus suis Infection, Vietnam V.T.L. Huong et al. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 20, No. 11, November 2014 1949 Antimicrobial Drug–Resistant Bacteria Isolated from Syrian November 2014 War–Injured Patients, Letters August 2011–March 2013 1951 Multidrug-Resistant IncA/C 1932 Mycobacterium tuberculosis Plasmid in Vibrio cholerae from Beijing Genotype Resistance to Haiti Transient Rifampin Exposure 1953 Human Co-Infection with Avian 1933 Bacteria in Dairy Products in and Seasonal Influenza Viruses, Baggage of Incoming Travelers, China Brazil 1955 Misidentification of 1935 Evidence of Evolving Diphyllobothrium Species Extraintestinal