--- articles: - contributors: [] description: "Background. Infections due to Vibrio species cause an estimated 8000 illnesses annually, often through consumption of undercooked seafood. Like foodborne Vibrio infections, nonfoodborne Vibrio infections (NFVI) also result in serious illness, but awareness of these infections is limited. Methods. We analyzed illnesses occuring during the period 1997-2006 that were reported to the Centers for Disease Control and Prevention's Cholera and Other Vibrio Illness Surveillance system. The diagnosis of NFVI required isolation of Vibrio species from a patient with contact with seawater. Results. Of 4754 Vibrio infections reported, 1210 (25%) were NFVIs. Vibrio vulnificus infections were the most common (accounting for 35% of NFVIs), with 72% of V. vulnificus infections reported from residents of Gulf Coast states. Infections due to V. vulnificus resulted in fever (72% of cases), cellulitis (85%), amputation (10%), and death (17%). V. vulnificus caused 62 NFVI-associated deaths (78%). Recreational activities accounted for 70% of exposures for patients with NFVIs associated with all species. Patients with liver disease were significantly more likely to die as a result of infection (odds ratio, 7.8; 95% confidence interval, 2.8-21.9). Regardless of pre-existing conditions, patients were more likely to die when hospitalization occurred >2 days after symptom onset (odds ratio, 2.9; 95% confidence interval, 1.8-4.8). Conclusion. NFVIs, especially those due to V. vulnificus, demonstrate high morbidity and mortality. Persons with liver disease should be advised of the risks associated with seawater exposure if a wound is already present or is likely to occur. Clinicians should consider Vibrio species as an etiologic agent in infections occurring in persons with recent seawater exposure, even if the individual was only exposed during recreational marine activities. Immediate antibiotic treatment with aggressive monitoring is advised in suspected cases. " display_name: 'Nonfoodborne Vibrio infections: An important cause of morbidity and mortality in the United States, 1997–2006' doi: 10.1086/529148 files: [] href: http://52.38.26.42:8080/article/10.1086/529148.yaml identifier: 10.1086/529148 journal_identifier: clinical-infectious-diseases journal_pages: 970-976 journal_vol: 46 notes: ~ parents: [] references: [] title: 'Nonfoodborne Vibrio infections: An important cause of morbidity and mortality in the United States, 1997–2006' type: article uri: /article/10.1086/529148 url: ~ year: 2008 - contributors: [] description: ~ display_name: An approach to prevention of infectious diseases during military deployments doi: 10.1086/510680 files: [] href: http://52.38.26.42:8080/article/10.1086/510680.yaml identifier: 10.1086/510680 journal_identifier: clinical-infectious-diseases journal_pages: 424-430 journal_vol: 44 notes: ~ parents: [] references: [] title: An approach to prevention of infectious diseases during military deployments type: article uri: /article/10.1086/510680 url: ~ year: 2007 - contributors: [] description: ~ display_name: 'Valley fever: Finding new places for an old disease: Coccidioides immitis found in Washington State soil associated with recent human infection' doi: 10.1093/cid/ciu681 files: [] href: http://52.38.26.42:8080/article/10.1093/cid/ciu681.yaml identifier: 10.1093/cid/ciu681 journal_identifier: clinical-infectious-diseases journal_pages: e1-e3 journal_vol: 60 notes: ~ parents: [] references: [] title: 'Valley fever: Finding new places for an old disease: Coccidioides immitis found in Washington State soil associated with recent human infection' type: article uri: /article/10.1093/cid/ciu681 url: ~ year: 2015 - contributors: [] description: ~ display_name: 'Invasive fungal pathogens: Current epidemiological trends' doi: 10.1086/504490 files: [] href: http://52.38.26.42:8080/article/10.1086/504490.yaml identifier: 10.1086/504490 journal_identifier: clinical-infectious-diseases journal_pages: S3-S14 journal_vol: 43 Supp 1 notes: ~ parents: [] references: [] title: 'Invasive fungal pathogens: Current epidemiological trends' type: article uri: /article/10.1086/504490 url: ~ year: 2006 - contributors: [] description: ~ display_name: 'Emerging Infections: In Harm’s Way: Infections in Deployed American Military Forces' doi: 10.1086/507539 files: [] href: http://52.38.26.42:8080/article/10.1086/507539.yaml identifier: 10.1086/507539 journal_identifier: clinical-infectious-diseases journal_pages: 1045-1051 journal_vol: 43 notes: ~ parents: [] references: [] title: 'Emerging Infections: In Harm’s Way: Infections in Deployed American Military Forces' type: article uri: /article/10.1086/507539 url: ~ year: 2006 - contributors: [] description: ~ display_name: 'Burden of self‐reported acute diarrheal illness in FoodNet surveillance areas, 1998–1999' doi: 10.1086/381590 files: [] href: http://52.38.26.42:8080/article/10.1086/381590.yaml identifier: 10.1086/381590 journal_identifier: clinical-infectious-diseases journal_pages: S219-S226 journal_vol: 38 notes: ~ parents: [] references: [] title: 'Burden of self‐reported acute diarrheal illness in FoodNet surveillance areas, 1998–1999' type: article uri: /article/10.1086/381590 url: ~ year: 2004 - contributors: [] description: ~ display_name: 'Risk Factors for the Hemolytic Uremic Syndrome in Children Infected With Escherichia coli O157:H7: A Multivariable Analysis' doi: 10.1093/cid/cis299 files: [] href: http://52.38.26.42:8080/article/10.1093/cid/cis299.yaml identifier: 10.1093/cid/cis299 journal_identifier: clinical-infectious-diseases journal_pages: 33-41 journal_vol: 55 notes: ~ parents: [] references: [] title: 'Risk Factors for the Hemolytic Uremic Syndrome in Children Infected With Escherichia coli O157:H7: A Multivariable Analysis' type: article uri: /article/10.1093/cid/cis299 url: ~ year: 2012 - contributors: [] description: 'Background. Naegleria fowleri is a climate-sensitive, thermophilic ameba found in the environment, including warm, freshwater lakes and rivers. Primary amebic meningoencephalitis (PAM), which is almost universally fatal, occurs when N. fowleri-containing water enters the nose, typically during swimming, and N. fowleri migrates to the brain via the olfactory nerve. In 2011, 2 adults died in Louisiana hospitals of infectious meningoencephalitis after brief illnesses. Methods. Clinical and environmental testing and case investigations were initiated to determine the cause of death and to identify the exposures. Results. Both patients had diagnoses of PAM. Their only reported water exposures were tap water used for household activities, including regular sinus irrigation with neti pots. Water samples, tap swab samples, and neti pots were collected from both households and tested; N. fowleri were identified in water samples from both homes. Conclusions. These are the first reported PAM cases in the United States associated with the presence of N. fowleri in household plumbing served by treated municipal water supplies and the first reports of PAM potentially associated with the use of a nasal irrigation device. These cases occurred in the context of an expanding geographic range for PAM beyond southern tier states with recent case reports from Minnesota, Kansas, and Virginia. These infections introduce an additional consideration for physicians recommending nasal irrigation and demonstrate the importance of using appropriate water (distilled, boiled, filtered) for nasal irrigation. Furthermore, the changing epidemiology of PAM highlights the importance of raising awareness about this disease among physicians treating persons showing meningitislike symptoms. ' display_name: Primary amebic meningoencephalitis deaths associated with sinus irrigation using contaminated tap water doi: 10.1093/cid/cis626 files: [] href: http://52.38.26.42:8080/article/10.1093/cid/cis626.yaml identifier: 10.1093/cid/cis626 journal_identifier: clinical-infectious-diseases journal_pages: e79-e85 journal_vol: 55 notes: ~ parents: [] references: [] title: Primary amebic meningoencephalitis deaths associated with sinus irrigation using contaminated tap water type: article uri: /article/10.1093/cid/cis626 url: ~ year: 2012 - contributors: - display_name: 'Author : Anna E. Newton (Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch) ' href: http://52.38.26.42:8080/contributor/21242.yaml id: 21242 organization: country_code: US display_name: Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch identifier: centers-disease-control-prevention-enteric-diseases-epidemiology-branch name: Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch organization_type_identifier: federal type: organization url: http://www.cdc.gov/ncezid/dfwed/edeb/ organization_uri: /organization/centers-disease-control-prevention-enteric-diseases-epidemiology-branch person: display_name: Anna E. Newton first_name: Anna E. id: 9519 last_name: Newton middle_name: ~ orcid: ~ type: person url: ~ person_id: 9519 person_uri: /person/9519 role_type_identifier: author uri: /contributor/21242 - display_name: 'Author : Anna E. Newton (Atlanta Research & Education Foundation) ' href: http://52.38.26.42:8080/contributor/21244.yaml id: 21244 organization: country_code: US display_name: Atlanta Research & Education Foundation identifier: atlanta-research-education-foundation name: Atlanta Research & Education Foundation organization_type_identifier: non-profit type: organization url: http://www.atlaref.org/ organization_uri: /organization/atlanta-research-education-foundation person: display_name: Anna E. Newton first_name: Anna E. id: 9519 last_name: Newton middle_name: ~ orcid: ~ type: person url: ~ person_id: 9519 person_uri: /person/9519 role_type_identifier: author uri: /contributor/21244 - display_name: 'Author : Magdalena Kendall (Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch) ' href: http://52.38.26.42:8080/contributor/21240.yaml id: 21240 organization: country_code: US display_name: Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch identifier: centers-disease-control-prevention-enteric-diseases-epidemiology-branch name: Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch organization_type_identifier: federal type: organization url: http://www.cdc.gov/ncezid/dfwed/edeb/ organization_uri: /organization/centers-disease-control-prevention-enteric-diseases-epidemiology-branch person: display_name: Magdalena Kendall first_name: Magdalena id: 6873 last_name: Kendall middle_name: ~ orcid: ~ type: person url: ~ person_id: 6873 person_uri: /person/6873 role_type_identifier: author uri: /contributor/21240 - display_name: 'Author : Magdalena Kendall (Atlanta Research & Education Foundation) ' href: http://52.38.26.42:8080/contributor/21246.yaml id: 21246 organization: country_code: US display_name: Atlanta Research & Education Foundation identifier: atlanta-research-education-foundation name: Atlanta Research & Education Foundation organization_type_identifier: non-profit type: organization url: http://www.atlaref.org/ organization_uri: /organization/atlanta-research-education-foundation person: display_name: Magdalena Kendall first_name: Magdalena id: 6873 last_name: Kendall middle_name: ~ orcid: ~ type: person url: ~ person_id: 6873 person_uri: /person/6873 role_type_identifier: author uri: /contributor/21246 - display_name: 'Author : Duc J. Vugia (California Department of Public Health Infectious Diseases Branch) ' href: http://52.38.26.42:8080/contributor/21247.yaml id: 21247 organization: country_code: US display_name: California Department of Public Health Infectious Diseases Branch identifier: california-department-public-health-infectious-diseases-branch name: California Department of Public Health Infectious Diseases Branch organization_type_identifier: state type: organization url: https://www.cdph.ca.gov/programs/idb/Pages/default.aspx organization_uri: /organization/california-department-public-health-infectious-diseases-branch person: display_name: Duc J. Vugia first_name: Duc J. id: 9517 last_name: Vugia middle_name: ~ orcid: ~ type: person url: ~ person_id: 9517 person_uri: /person/9517 role_type_identifier: author uri: /contributor/21247 - display_name: 'Author : Olga Henao (Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch) ' href: http://52.38.26.42:8080/contributor/21238.yaml id: 21238 organization: country_code: US display_name: Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch identifier: centers-disease-control-prevention-enteric-diseases-epidemiology-branch name: Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch organization_type_identifier: federal type: organization url: http://www.cdc.gov/ncezid/dfwed/edeb/ organization_uri: /organization/centers-disease-control-prevention-enteric-diseases-epidemiology-branch person: display_name: Olga Henao first_name: Olga id: 11576 last_name: Henao middle_name: L. orcid: ~ type: person url: ~ person_id: 11576 person_uri: /person/11576 role_type_identifier: author uri: /contributor/21238 - display_name: 'Author : Barbara E. Mahon (Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch) ' href: http://52.38.26.42:8080/contributor/21239.yaml id: 21239 organization: country_code: US display_name: Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch identifier: centers-disease-control-prevention-enteric-diseases-epidemiology-branch name: Centers for Disease Control and Prevention Enteric Diseases Epidemiology Branch organization_type_identifier: federal type: organization url: http://www.cdc.gov/ncezid/dfwed/edeb/ organization_uri: /organization/centers-disease-control-prevention-enteric-diseases-epidemiology-branch person: display_name: Barbara E. Mahon first_name: Barbara E. id: 6876 last_name: Mahon middle_name: ~ orcid: ~ type: person url: http://www.cdc.gov/women/stem/mahon.htm person_id: 6876 person_uri: /person/6876 role_type_identifier: author uri: /contributor/21239 - display_name: 'Funding Agency : Division of Foodborne, Waterborne, and Environmental Diseases ' href: http://52.38.26.42:8080/contributor/21251.yaml id: 21251 organization: country_code: US display_name: 'Division of Foodborne, Waterborne, and Environmental Diseases' identifier: division-foodborne-waterborne-environmental-diseases name: 'Division of Foodborne, Waterborne, and Environmental Diseases' organization_type_identifier: federal type: organization url: http://www.cdc.gov/ncezid/dfwed/ organization_uri: /organization/division-foodborne-waterborne-environmental-diseases person: {} person_id: ~ person_uri: ~ role_type_identifier: funding_agency uri: /contributor/21251 - display_name: 'Funding Agency : Association of Public Health Laboratories ' href: http://52.38.26.42:8080/contributor/21254.yaml id: 21254 organization: country_code: US display_name: Association of Public Health Laboratories identifier: association-public-health-laboratories name: Association of Public Health Laboratories organization_type_identifier: professional society/organization type: organization url: http://www.aphl.org/Pages/default.aspx organization_uri: /organization/association-public-health-laboratories person: {} person_id: ~ person_uri: ~ role_type_identifier: funding_agency uri: /contributor/21254 description: 'Background. The Centers for Disease Control and Prevention monitors vibriosis through 2 surveillance systems: the nationwide Cholera and Other Vibrio Illness Surveillance (COVIS) system and the 10-state Foodborne Diseases Active Surveillance Network (FoodNet). COVIS conducts passive surveillance and FoodNet conducts active surveillance for laboratory-confirmed Vibrio infections. Methods. We summarized Vibrio infections (excluding toxigenic V. cholerae O1 and O139) reported to COVIS and FoodNet from 1996 through 2010. For each system, we calculated incidence rates using US Census Bureau population estimates for the surveillance area. Results. From 1996 to 2010, 7700 cases of vibriosis were reported to COVIS and 1519 to FoodNet. Annual incidence of reported vibriosis per 100 000 population increased from 1996 to 2010 in both systems, from 0.09 to 0.28 in COVIS and from 0.15 to 0.42 in FoodNet. The 3 commonly reported Vibrio species were V. parahaemolyticus, V. vulnificus, and V. alginolyticus; both surveillance systems showed that the incidence of each increased. In both systems, most hospitalizations and deaths were caused by V. vulnificus infection, and most patients were white men. The number of cases peaked in the summer months. Conclusions. Surveillance data from both COVIS and FoodNet indicate that the incidence of vibriosis increased from 1996 to 2010 overall and for each of the 3 most commonly reported species. Epidemiologic patterns were similar in both systems. Current prevention efforts have failed to prevent increasing rates of vibriosis; more effective efforts will be needed to decrease rates. ' display_name: 'Increasing Rates of Vibriosis in the United States, 1996-2010: Review of Surveillance Data From 2 Systems' doi: 10.1093/cid/cis243 files: [] href: http://52.38.26.42:8080/article/10.1093/cid/cis243.yaml identifier: 10.1093/cid/cis243 journal_identifier: clinical-infectious-diseases journal_pages: S391-S395 journal_vol: 54 notes: ~ parents: [] references: [] title: 'Increasing Rates of Vibriosis in the United States, 1996-2010: Review of Surveillance Data From 2 Systems' type: article uri: /article/10.1093/cid/cis243 url: ~ year: 2012 - contributors: [] description: 'Background. Naegleria fowleri is a climate-sensitive, thermophilic ameba found in warm, freshwater lakes and rivers. Primary amebic meningoencephalitis (PAM), which is almost universally fatal, occurs when N. fowleri-containing water enters the nose, typically during swimming, and migrates to the brain via the olfactory nerve. In August 2013, a 4-year-old boy died of meningoencephalitis of unknown etiology in a Louisiana hospital. Methods. Clinical and environmental testing and a case investigation were initiated to determine the cause of death and to identify potential exposures. Results. Based on testing of cerebrospinal fluid and brain specimens, the child was diagnosed with PAM. His only reported water exposure was tap water; in particular, tap water that was used to supply water to a lawn water slide on which the child had played extensively prior to becoming ill. Water samples were collected from both the home and the water distribution system that supplied the home and tested; N. fowleri was identified in water samples from both the home and the water distribution system. Conclusions. This case is the first reported PAM death associated with culturable N. fowleri in tap water from a US treated drinking water system. This case occurred in the context of an expanding geographic range for PAM beyond southern states, with recent case reports from Minnesota, Kansas, and Indiana. This case also highlights the role of adequate disinfection throughout drinking water distribution systems and the importance of maintaining vigilance when operating drinking water systems using source waters with elevated temperatures. ' display_name: The First Association of a Primary Amebic Meningoencephalitis Death With Culturable Naegleria fowleri in Tap Water From a US Treated Public Drinking Water System doi: 10.1093/cid/civ017 files: [] href: http://52.38.26.42:8080/article/10.1093/cid/civ017.yaml identifier: 10.1093/cid/civ017 journal_identifier: clinical-infectious-diseases journal_pages: e36-e42 journal_vol: 60 notes: ~ parents: [] references: [] title: The First Association of a Primary Amebic Meningoencephalitis Death With Culturable Naegleria fowleri in Tap Water From a US Treated Public Drinking Water System type: article uri: /article/10.1093/cid/civ017 url: ~ year: 2015 - contributors: [] description: "Background. Primary amebic meningoencephalitis (PAM), caused by the free-living ameba Naegleria fowleri, has historically been associated with warm freshwater exposures at lower latitudes of the United States. In August 2010, a Minnesota resident, aged 7 years, died of rapidly progressive meningoencephalitis after local freshwater exposures, with no history of travel outside the state. PAM was suspected on the basis of amebae observed in cerebrospinal fluid. Methods. Water and sediment samples were collected at locations where the patient swam during the 2 weeks preceding illness onset. Patient and environmental samples were tested for N. fowleri with use of culture and real-time polymerase chain reaction (PCR); isolates were genotyped. Historic local ambient temperature data were obtained. Results. N. fowleri isolated from a specimen of the patient's brain and from water and sediment samples was confirmed using PCR as N. fowleri genotype 3. Surface water temperatures at the times of collection of the positive environmental samples ranged from 22.1degC to 24.5degC. August 2010 average air temperature near the exposure site was 25degC, 3.6degC above normal and the third warmest for August in the Minneapolis area since 1891. Conclusions. This first reported case of PAM acquired in Minnesota occurred 550 miles north of the previously reported northernmost case in the Americas. Clinicians should be aware that N. fowleri-associated PAM can occur in areas at much higher latitude than previously described. Local weather patterns and long-term climate change could impact the frequency of PAM. " display_name: 'Fatal Naegleria fowleri infection acquired in Minnesota: Possible expanded range of a deadly thermophilic organism' doi: 10.1093/cid/cir961 files: [] href: http://52.38.26.42:8080/article/10.1093/cid/cir961.yaml identifier: 10.1093/cid/cir961 journal_identifier: clinical-infectious-diseases journal_pages: 805-809 journal_vol: 54 notes: ~ parents: [] references: [] title: 'Fatal Naegleria fowleri infection acquired in Minnesota: Possible expanded range of a deadly thermophilic organism' type: article uri: /article/10.1093/cid/cir961 url: ~ year: 2012 - contributors: [] description: 'Background. Diarrhea remains an important cause of morbidity, but until the mid 1990s, hospital admissions for diarrhea in the US adult population were declining. We aimed to describe recent trends in gastroenteritis hospitalizations and to determine the contribution of norovirus. Methods. We analyzed all gastroenteritis-associated hospital discharges during 1996-2007 from a nationally representative data set of hospital inpatient stays. Annual rates of discharges by age were calculated. Time-series regression models were fitted using cause-specified discharges as explanatory variables; model residuals were analyzed to estimate norovirus- and rotavirus-associated discharges. We then calculated the annual hospital charges for norovirus-associated discharges. Results. Sixty-nine percent of all gastroenteritis discharges were cause-unspecified and rates increased by [?]50% in all adult and elderly age groups ([?]18 years of age) from 1996 through 2007. We estimate an annual mean of 71,000 norovirus-associated hospitalizations, costing $493 million per year, with surges to nearly 110,000 hospitalizations per year in epidemic seasons. We also estimate 24,000 rotavirus hospitalizations annually among individuals aged [?]5 years. Conclusions. Gastroenteritis hospitalizations are increasing, and we estimate that norovirus is the cause of 10% of cause-unspecified and 7% of all-cause gastroenteritis discharges. Norovirus should be routinely considered as a cause of gastroenteritis hospitalization. ' display_name: 'Increasing rates of gastroenteritis hospital discharges in US adults and the contribution of norovirus, 1996-2007' doi: 10.1093/cid/ciq163 files: [] href: http://52.38.26.42:8080/article/10.1093/cid/ciq163.yaml identifier: 10.1093/cid/ciq163 journal_identifier: clinical-infectious-diseases journal_pages: 466-474 journal_vol: 52 notes: ~ parents: [] references: [] title: 'Increasing rates of gastroenteritis hospital discharges in US adults and the contribution of norovirus, 1996-2007' type: article uri: /article/10.1093/cid/ciq163 url: ~ year: 2011 cited_by: [] contributors: - display_name: 'Publisher : Oxford University Press ' href: http://52.38.26.42:8080/contributor/13066.yaml id: 13066 organization: country_code: UK display_name: Oxford University Press identifier: oxford-university-press name: Oxford University Press organization_type_identifier: commercial type: organization url: http://global.oup.com/?cc=us organization_uri: /organization/oxford-university-press person: {} person_id: ~ person_uri: ~ role_type_identifier: publisher uri: /contributor/13066 country: ~ description: ~ display_name: Clinical Infectious Diseases files: - display_name: 10.cover.gif file: /content/60/10.cover.gif href: http://cid.oxfordjournals.org/content/60/10.cover.gif identifier: 7f849efd-d7fb-4f94-b294-d1484f524a2f landing_page: ~ location: http://cid.oxfordjournals.org mime_type: image/gif sha1: f2f41b38183936c623b044ed7f50d636b6298e13 size: 9398 thumbnail: db/b4/52261619e21c25d92a92a3115e1e/.thumb-7f849efd-d7fb-4f94-b294-d1484f524a2f.png thumbnail_href: http://data.globalchange.gov/assets/db/b4/52261619e21c25d92a92a3115e1e/.thumb-7f849efd-d7fb-4f94-b294-d1484f524a2f.png type: file uri: /file/7f849efd-d7fb-4f94-b294-d1484f524a2f url: http://cid.oxfordjournals.org/content/60/10.cover.gif href: http://52.38.26.42:8080/journal/clinical-infectious-diseases.yaml identifier: clinical-infectious-diseases notes: ~ online_issn: 1537-6591 parents: [] print_issn: 1058-4838 publisher: Oxford University Press references: [] title: Clinical Infectious Diseases type: journal uri: /journal/clinical-infectious-diseases url: https://cid.oxfordjournals.org/