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  • 1. Abbara, Aula
    et al.
    Al-Harbat, Nizar
    Karah, Nabil
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten).
    Abo-Yahya, Bashar
    El-Amin, Wael
    Hatcher, James
    Gabbar, Omar
    Antimicrobial Drug Resistance among Refugees from Syria, Jordan2017Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 23, nr 5, s. 885-886Artikel i tidskrift (Refereegranskat)
  • 2. Ariza-Miguel, Jaime
    et al.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Fernández-Natal, María Isabel
    Martínez-Nistal, Carmen
    Orduña, Antonio
    Rodríguez-Ferri, Elías F
    Hernández, Marta
    Rodríguez-Lázaro, David
    Molecular investigation of tularemia outbreaks, Spain, 1997-20082014Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 20, nr 5, s. 754-761Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Tularemia outbreaks occurred in northwestern Spain in 1997-1998 and 2007-2008 and affected >1,000 persons. We assessed isolates involved in these outbreaks by using pulsed-field gel electrophoresis with 2 restriction enzymes and multilocus variable number tandem repeat analysis of 16 genomic loci of Francisella tularensis, the cause of this disease. Isolates were divided into 3 pulsotypes by pulsed-field gel electrophoresis and 8 allelic profiles by multilocus variable number tandem repeat analysis. Isolates obtained from the second tularemia outbreak had the same genotypes as isolates obtained from the first outbreak. Both outbreaks were caused by genotypes of genetic subclade B.Br:FTNF002-00, which is widely distributed in countries in central and western Europe. Thus, reemergence of tularemia in Spain was not caused by the reintroduction of exotic strains, but probably by persistence of local reservoirs of infection.

  • 3. Birdsell, Dawn N
    et al.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Öhrman, Caroline
    Swedish Defense Research Agency, Umeå.
    Kaufman, Emily
    Molins, Claudia
    Pearson, Talima
    Gyuranecz, Miklós
    Naumann, Amber
    Vogler, Amy J
    Myrtennäs, Kerstin
    Swedish Defense Research Agency, Umeå.
    Larsson, Pär
    Swedish Defense Research Agency, Umeå.
    Forsman, Mats
    Swedish Defense Research Agency, Umeå.
    Sjödin, Andreas
    Swedish Defense Research Agency, Umeå.
    Gillece, John D
    Schupp, James
    Petersen, Jeannine M
    Keim, Paul
    Wagner, David M
    Francisella tularensis subsp. tularensis group A.I, United States2014Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 20, nr 5, s. 861-865Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We used whole-genome analysis and subsequent characterization of geographically diverse strains using new genetic signatures to identify distinct subgroups within Francisella tularensis subsp. tularensis group A.I: A.I.3, A.I.8, and A.I.12. These subgroups exhibit complex phylogeographic patterns within North America. The widest distribution was observed for A.I.12, which suggests an adaptive advantage.

  • 4. Bruce, Michael G
    et al.
    Deeks, Shelley L
    Zulz, Tammy
    Bruden, Dana
    Navarro, Christine
    Lovgren, Marguerite
    Jette, Louise
    Kristinsson, Karl
    Sigmundsdottir, Gudrun
    Jensen, Knud Brinkløv
    Lovoll, Oistein
    Nuorti, J Pekka
    Herva, Elja
    Nystedt, Anders
    Sjostedt, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk bakteriologi.
    Koch, Anders
    Hennessy, Thomas W
    Parkinson, Alan J
    International Circumpolar Surveillance System for invasive pneumococcal disease, 1999-20052008Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 14, nr 1, s. 25-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The International Circumpolar Surveillance System is a population-based surveillance network for invasive bacterial disease in the Arctic. The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced for routine infant vaccination in Alaska (2001), northern Canada (2002-2006), and Norway (2006). Data for invasive pneumococcal disease (IPD) were analyzed to identify clinical findings, disease rates, serotype distribution, and antimicrobial drug susceptibility; 11,244 IPD cases were reported. Pneumonia and bacteremia were common clinical findings. Rates of IPD among indigenous persons in Alaska and northern Canada were 43 and 38 cases per 100,000 population, respectively. Rates in children <2 years of age ranged from 21 to 153 cases per 100,000 population. In Alaska and northern Canada, IPD rates in children <2 years of age caused by PCV7 serotypes decreased by >80% after routine vaccination. IPD rates are high among indigenous persons and children in Arctic countries. After vaccine introduction, IPD caused by non-PCV7 serotypes increased in Alaska.

  • 5. Cohen, Adam L.
    et al.
    Hellferscee, Orienka
    Pretorius, Marthi
    Treurnicht, Florette
    Walaza, Sibongile
    Madhi, Shabir
    Groome, Michelle
    Dawood, Halima
    Variava, Ebrahim
    Kahn, Kathleen
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. University of Witwatersrand, Johannesburg, South Africa and INDEPTH Network, Accra, Ghana.
    Wolter, Nicole
    von Gottberg, Anne
    Tempia, Stefano
    Venter, Marietjie
    Cohen, Cheryl
    Epidemiology of Influenza Virus Types and Subtypes in South Africa, 2009-20122014Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 20, nr 7, s. 1162-1169Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To determine clinical and epidemiologic differences between influenza caused by different virus types and subtypes, we identified patients and tested specimens. Patients were children and adults hospitalized with confirmed influenza and severe acute respiratory illness (SARI) identified through active, prospective, hospital-based surveillance from 2009-2012 in South Africa. Respiratory specimens were tested, typed, and subtyped for influenza virus by PCR. Of 16,005 SARI patients tested, 1,239 (8%) were positive for influenza virus. Patient age and co-infections varied according to virus type and subtype, but disease severity did not. Case-patients with influenza B were more likely than patients with influenza A to be HIV infected. A higher proportion of case-patients infected during the first wave of the 2009 influenza pandemic were 5-24 years of age (19%) than were patients infected during the second wave (9%). Although clinical differences exist, treatment recommendations do not differ according to subtype; prevention through vaccination is recommended.

  • 6. Cohen, Cheryl
    et al.
    Moyes, Jocelyn
    Tempia, Stefano
    Groom, Michelle
    Walaza, Sibongile
    Pretorius, Marthi
    Dawood, Halima
    Chhagan, Meera
    Haffejee, Summaya
    Variava, Ebrahim
    Kahn, Kathleen
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Tshangela, Akhona
    von Gottberg, Anne
    Wolter, Nicole
    Cohen, Adam L.
    Kgokong, Babatyi
    Venter, Marietjie
    Madhi, Shabir A.
    Severe Influenza-associated Respiratory Infection in High HIV Prevalence Setting, South Africa, 2009-20112013Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 19, nr 11, s. 1766-1774Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Data on influenza epidemiology in HIV-infected persons are limited, particularly for sub-Saharan Africa, where HIV infection is widespread. We tested respiratory and blood samples from patients with acute lower respiratory tract infections hospitalized in South Africa during 2009-2011 for viral and pneumococcal infections. Influenza was identified in 9% (1,056/11,925) of patients enrolled; among influenza case-patients, 358 (44%) of the 819 who were tested were infected with HIV. Influenza-associated acute lower respiratory tract infection incidence was 4-8 times greater for HIV-infected (186-228/100,000) than for HIV-uninfected persons (26-54/100,000). Furthermore, multivariable analysis showed HIV-infected patients were more likely to have pneumococcal co-infection; to be infected with influenza type B compared with type A; to be hospitalized for 2-7 days or >7 days; and to die from their illness. These findings indicate that HIV-infected persons are at greater risk for severe illnesses related to influenza and thus should be prioritized for influenza vaccination.

  • 7.
    Connolly-Andersson, Anne-Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Ahlm, Kristin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Ahlm, Clas
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Klingström, Jonas
    Puumala virus infections associated with cardiovascular causes of death2013Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 19, nr 1, s. 126-128Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We studied the causes of death of patients in Sweden with diagnoses of hemorrhagic fever with renal syndrome (HFRS) during 1997–2009. Cardiovascular disorders were a common cause of death during acute-phase HFRS and were the cause of death for >50% of those who died during the first year after HFRS.

  • 8.
    Desvars, Amélie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Furberg, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Hjertqvist, Marika
    Vidman, Linda
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Sjöstedt, Anders
    Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS).
    Rydén, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Epidemiology and Ecology of Tularemia in Sweden, 1984-20122015Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 21, nr 1, s. 32-39Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The zoonotic disease tularemia is endemic in large areas of the Northern Hemisphere, but research is lacking on patterns of spatial distribution and connections with ecologic factors. To describe the spatial epidemiology of and identify ecologic risk factors for tularemia incidence in Sweden, we analyzed surveillance data collected over 29 years (1984-2012). A total of 4,830 cases were notified, of which 3,524 met all study inclusion criteria. From the first to the second half of the study period, mean incidence increased 10-fold, from 0.26/100,000 persons during 1984-1998 to 2.47/100,000 persons during 1999 2012 (p<0.001). The incidence of tularemia was higher than expected in the boreal and alpine ecologic regions (p<0.001), and incidence was positively correlated with the presence of lakes and rivers (p<0.001). These results provide a comprehensive epidemiologic description of tularemia in Sweden and illustrate that incidence is higher in locations near lakes and rivers.

  • 9.
    Gylfe, Åsa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk bakteriologi.
    Ribers, Åsa
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Forsman, Oscar
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Bucht, Göran
    Alenius, Gerd-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Wållberg-Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Ahlm, Clas
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Evander, Magnus
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Mosquitoborne Sindbis Virus Infection and Long-Term Illness2018Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 24, nr 6, s. 1141-1142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An unexpected human outbreak of the mosquitoborne Sindbis virus occurred in a previously nonendemic area of Sweden. At follow-up, 6-8 months after infection, 39% of patients had chronic arthralgia that affected their daily activities. Vectorborne infections may disseminate rapidly into new areas and cause acute and chronic disease.

  • 10. Gyuranecz, Miklos
    et al.
    Birdsell, Dawn N.
    Splettstoesser, Wolf
    Seibold, Erik
    Beckstrom-Sternberg, Stephen M.
    Makrai, Laszlo
    Fodor, Laszlo
    Fabbi, Massimo
    Vicari, Nadia
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Busch, Joseph D.
    Vogler, Amy J.
    Keim, Paul
    Wagner, David M.
    Phylogeography of Francisella tularensis subsp holarctica, Europe2012Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 18, nr 2, s. 290-293Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Francisella tularensis subsp. holarctica isolates from Austria, Germany, Hungary, Italy, and Romania were placed into an existing phylogeographic framework. Isolates from Italy were assigned to phylogenetic group B.FTNF002-00; the other isolates, to group B.13. Most F tularensis subsp. holarctica isolates from Europe belong to these 2 geographically segregated groups.

  • 11. Henningsson, Anna J.
    et al.
    Lindqvist, Richard
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Norberg, Peter
    Lindblom, Pontus
    Roth, Anette
    Forsberg, Pia
    Bergström, Tomas
    Överby, Anna K.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Lindgren, Per-Eric
    Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick2016Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 22, nr 8, s. 1485-1487Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We report a case of human tick-borne encephalitis (TBE) in which the TBE virus was isolated from the biting tick. Viral growth and sequence were characterized and compared with those of a reference strain. Virus isolation from ticks from patients with TBE may offer a new approach for studies of epidemiology and pathogenicity.

  • 12. Herrmann, Björn
    et al.
    Persson, Heléna
    Jensen, Jens-Kjeld
    Joensen, Høgni Debes
    Klint, Markus
    Olsen, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Chlamydophila psittaci in Fulmars, the Faroe Islands.2006Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 12, nr 2, s. 330-2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chlamydophila psittaci was detected in 10% of 431 fulmars examined from the Faroe Islands. Analysis of ompA showed a sequence almost identical to that of the type strain. The origin of C. psittaci outbreaks in fulmars is discussed. Despite a high level of exposure, the risk for transmission of C. psittaci to humans is low.

  • 13. Hjertqvist, Marika
    et al.
    Klein, Sabra L
    Ahlm, Clas
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Klingström, Jonas
    Mortality rate patterns for hemorrhagic fever with renal syndrome caused by Puumala virus2010Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 16, nr 10, s. 1584-1586Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To investigate nephropathia epidemica in Sweden during 1997-2007, we determined case-fatality rates for 5,282 patients with this disease. Overall, 0.4% died of acute nephropathia epidemica ≤3 months after diagnosis. Case-fatality rates increased with age. Only women showed an increased case-fatality rate during the first year after diagnosis.

  • 14. Hoffman, Tove
    et al.
    Lindeborg, Mats
    Barboutis, Christos
    Erciyas-Yavuz, Kiraz
    Evander, Magnus
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Fransson, Thord
    Figuerola, Jordi
    Jaenson, Thomas G. T.
    Kiat, Yosef
    Lindgren, Per-Eric
    Lundkvist, Åke
    Mohamed, Nahla
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Moutailler, Sara
    Nyström, Fredrik
    Olsen, Björn
    Salaneck, Erik
    Alkhurma Hemorrhagic Fever Virus RNA in Hyalomma rufipes Ticks Infesting Migratory Birds, Europe and Asia Minor2018Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 24, nr 5, s. 879-882Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Alkhurma hemorrhagic fever virus RNA was detected in immature Hyalomma rufipes ticks infesting northward migratory birds caught in the North Mediterranean Basin. This finding suggests a role for birds in the ecology of the Alkhurma hemorrhagic fever virus and a potential mechanism for dissemination to novel regions. Increased surveillance is warranted.

  • 15.
    Kurhade, Chaitanya
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi. Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS).
    Schreier, Sarah
    Lee, Yi-Ping
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi. National Cheng Kung University, Tainan, Taiwan..
    Zegenhagen, Loreen
    Hjertqvist, Marika
    Dobler, Gerhard
    Kroeger, Andrea
    Överby, Anna K.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi. Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS).
    Correlation of Severity of Human Tick-Borne Encephalitis Virus Disease and Pathogenicity in Mice2018Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 24, nr 9, s. 1709-1712Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We compared 2 tick-borne encephalitis virus strains isolated from 2 different foci that cause different symptoms in tick-borne encephalitis patients, from neurologic to mild gastrointestinal symptoms. We compared neuroinvasiveness, neurovirulence, and proinflammatory cytokine response in mice and found unique differences that contribute to our understanding of pathogenesis.

  • 16.
    Larsson, Pär
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk bakteriologi.
    Svensson, Kerstin
    FOI, Umeå (Swedish Defence Research Agency).
    Karlsson, Linda
    Guala, Dimitri
    Granberg, Malin
    Forsman, Mats
    FOI, Umeå (Swedish Defence Research Agency).
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Canonical insertion-deletion markers for rapid DNA typing of Francisella tularensis2007Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 13, nr 11, s. 1725-1732Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To develop effective and accurate typing of strains of Francisella tularensis, a potent human pathogen and a putative bioterrorist agent, we combined analysis of insertion-deletion (indel) markers with multiple-locus variable-number tandem repeat analysis (MLVA). From 5 representative F. tularensis genome sequences, 38 indel markers with canonical properties, i.e., capable of sorting strains into major genetic groups, were selected. To avoid markers with a propensity for homoplasy, we used only those indels with 2 allelic variants and devoid of substantial sequence repeats. MLVA included sequences with much diversity in copy number of tandem repeats. The combined procedure allowed subspecies division, delineation of clades A.I and A.II of subspecies tularensis, differentiation of Japanese strains from other strains of subspecies holarctica, and high-resolution strain typing. The procedure uses limited amounts of killed bacterial preparations and, because only 1 single analytic method is needed, is time- and cost-effective.

  • 17. Munster, Vincent J
    et al.
    Wallensten, Anders
    Baas, Chantal
    Rimmelzwaan, Guus F
    Schutten, Martin
    Olsen, Björn
    Kalmar University, Kalmar, Sweden..
    Osterhaus, Albert D M E
    Fouchier, Ron A M
    Mallards and highly pathogenic avian influenza ancestral viruses, northern Europe2005Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 11, nr 10, s. 1545-1551Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Outbreaks of highly pathogenic avian influenza (HPAI), which originate in poultry upon transmission of low pathogenic viruses from wild birds, have occurred relatively frequently in the last decade. During our ongoing surveillance studies in wild birds, we isolated several influenza A viruses of hemagglutinin subtype H5 and H7 that contain various neuraminidase subtypes. For each of the recorded H5 and H7 HPAI outbreaks in Europe since 1997, our collection contained closely related virus isolates recovered from wild birds, as determined by sequencing and phylogenetic analyses of the hemagglutinin gene and antigenic characterization of the hemagglutinin glycoprotein. The minor genetic and antigenic diversity between the viruses recovered from wild birds and those causing HPAI outbreaks indicates that influenza A virus surveillance studies in wild birds can help generate prototypic vaccine candidates and design and evaluate diagnostic tests, before outbreaks occur in animals and humans.

  • 18. Nordstrand, Annika
    et al.
    Bunikis, Ignas
    Umeå universitet, Medicinsk fakultet, Molekylärbiologi (Medicinska fakulteten).
    Larsson, Christer
    Umeå universitet, Medicinsk fakultet, Molekylärbiologi (Medicinska fakulteten).
    Tsogbe, Kodjo
    Schwan, Tom G
    Nilsson, Mikael
    Bergström, Sven
    Umeå universitet, Medicinsk fakultet, Molekylärbiologi (Medicinska fakulteten).
    Tickborne relapsing fever diagnosis obscured by malaria, Togo.2007Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 13, nr 1, s. 117-123Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Given the prevalence of relapsing fever (RF) in Senegal, this disease may cause illness and death in other areas of West Africa. We performed a cross-sectional, clinic-based study to investigate the presence of RF in Togo during 2002-2004. Blood samples from patients with fever were examined for RF spirochetes by microscopy, PCR, and DNA sequencing of amplicons and for antibodies to the glycerophosphodiester phosphodiesterase antigen. Although no spirochetes were seen in blood smears, approximately 10% of the patients were positive by PCR and approximately 13% were seropositive for spirochetes. DNA sequencing demonstrated that Borrelia crocidurae and B. duttonii were present. Most patients were treated for malaria whether or not plasmodia were observed. Thus, many RF patients originally had a misdiagnosis of malaria, which resulted in ineffective treatment. The inability of microscopic analysis to detect spirochetes compared with PCR demonstrates the need for tests with greater sensitivity.

  • 19. Olsson , GE
    et al.
    Hjertqvist , M
    Lundkvist , Å
    Hörnfeldt , Birger
    Umeå universitet, Teknisk-naturvetenskaplig fakultet, Ekologi, miljö och geovetenskap.
    Predicting High Risk for Human Hantavirus Infections, Sweden2009Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 15, nr 1, s. 104-106Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An increased risk for hemorrhagic fever with renal syndrome caused by Puumala hantavirus was forecast for Sweden in 2007. The forecast was based on a predicted increase in the number of Myodes glareolus rodents (reservoir hosts). Despite raised awareness and preparedness, the number of human cases during July 2007-June 2008 was 1,483, a new high.

  • 20.
    Olsson, Gert E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Dalerum, Fredrik
    Hörnfeldt, Birger
    Elgh, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Palo, Thomas R
    Juto, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Ahlm, Clas
    Human hantavirus infections, Sweden.2003Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 9, nr 11, s. 1395-401Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The prevalent human hantavirus disease in Sweden is nephropathia epidemica, which is caused by Puumala virus and shed by infected bank voles (Clethrionomys glareolus). To evaluate temporal and spatial patterns of this disease, we studied 2,468 reported cases from a highly disease-endemic region in northern Sweden. We found that, in particular, middle-aged men living in rural dwellings near coastal areas were overrepresented. The case-patients were most often infected in late autumn, when engaged in activities near or within manmade rodent refuges. Of 862 case-patients confident about the site of virus exposure, 50% were concentrated within 5% of the study area. The incidence of nephropathia epidemica was significantly correlated with bank vole numbers within monitored rodent populations in part of the region. Understanding this relationship may help forestall future human hantavirus outbreaks.

  • 21.
    Olsson, Gert E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    White, Neil
    Ahlm, Clas
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Elgh, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Verlemyr, Ann-Christin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Juto, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Palo, R Thomas
    Demographic factors associated with hantavirus infection in bank voles (Clethrionomys glareolus)2002Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 8, nr 9, s. 924-929Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The bank vole (Clethrionomys glareolus) is the natural reservoir of Puumala virus (PUUV), a species in the genus Hantavirus. PUUV is the etiologic agent of nephropathia epidemica, a mild form of hemorrhagic fever with renal syndrome. Factors that influence hantavirus transmission within host populations are not well understood. We evaluated a number of factors influencing on the association of increased PUUV infection in bank voles captured in a region in northern Sweden endemic for the virus. Logistic regression showed four factors that together correctly predicted 80% of the model outcome: age, body mass index, population phase during sampling (increase, peak, or decline/low), and gender. This analysis highlights the importance of population demography in the successful circulation of hantavirus. The chance of infection was greatest during the peak of the population cycle, implying that the likelihood of exposure to hantavirus increases with increasing population density.

  • 22.
    Ozsurekci, Yasemin
    et al.
    Hacettepe Univ, Ankara, Turkey.
    Birdsell, Dawn N.
    No Arizona Univ, Flagstaff, AZ 86011 USA.
    Celik, Melda
    Hacettepe Univ, Ankara, Turkey.
    Karadag-Oncel, Eda
    Hacettepe Univ, Ankara, Turkey.
    Johansson, Anders
    Umeå universitet.
    Forsman, Mats
    Swedish Def Res Agcy, Umea, Sweden.
    Vogler, Amy J.
    No Arizona Univ, Flagstaff, AZ 86011 USA.
    Keim, Paul
    No Arizona Univ, Flagstaff, AZ 86011 USA, Translat Genom Res Inst, Flagstaff, AZ USA.
    Ceyhan, Mehmet
    Hacettepe Univ, Ankara, Turkey.
    Wagner, David M.
    No Arizona Univ, Flagstaff, AZ 86011 USA.
    Diverse Francisella tularensis Strains and Oropharyngeal Tularemia, Turkey2015Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 21, nr 1, s. 173-175Artikel i tidskrift (Refereegranskat)
  • 23. Pilo, Paola
    et al.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk bakteriologi. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar. Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS).
    Frey, Joachim
    Identification of Francisella tularensis cluster in Central and Western Europe2009Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 15, nr 12, s. 2049-2051Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We conducted a molecular analysis of Francisella Marensis strains isolated in Switzerland and identified a specific subpopulation belonging to a cluster of F tularensis subsp. holarctica that is widely dispersed in central and western continental Europe. This subpopulation was present before the tularemia epidemics on the Iberian Peninsula.

  • 24.
    Rocklöv, Joacim
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Tozan, Yesim
    Ramadona, Aditya Lia
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Sewe, Maquins Odhiambo
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Sudre, Bertrand
    Garrido, Jon
    de Saint Lary, Chiara Bellegarde
    Lohr, Wolfgang
    Semenza, Jan C.
    Using Big Data to Monitor the Introduction and Spread of Chikungunya, Europe, 20172019Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 25, nr 6, s. 1041-1049Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    With regard to fully harvesting the potential of big data, public health lags behind other fields. To determine this potential, we applied big data (air passenger volume from international areas with active chikungunya transmission, Twitter data, and vectorial capacity estimates of Aedes albopictus mosquitoes) to the 2017 chikungunya outbreaks in Europe to assess the risks for virus transmission, virus importation, and short-range dispersion from the outbreak foci. We found that indicators based on voluminous and velocious data can help identify virus dispersion from outbreak foci and that vector abundance and vectorial capacity estimates can provide information on local climate suitability for mosquitoborne outbreaks. In contrast, more established indicators based on Wikipedia and Google Trends search strings were less timely. We found that a combination of novel and disparate datasets can be used in real time to prevent and control emerging and reemerging infectious diseases.

  • 25. Semenza, Jan C.
    et al.
    Lindgren, Elisabet
    Balkanyi, Laszlo
    Espinosa, Laura
    Almqvist, My S.
    Penttinen, Pasi
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Determinants and Drivers of Infectious Disease Threat Events in Europe2016Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 22, nr 4, s. 581-589Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Infectious disease threat events (IDTEs) are increasing in frequency worldwide. We analyzed underlying drivers of 116 IDTEs detected in Europe during 2008-2013 by epidemic intelligence at the European Centre of Disease Prevention and Control. Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. A combination of >= 2 drivers was responsible for most IDTEs. The driver category globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate. Hierarchical cluster analysis of all drivers identified travel and tourism as a distinctly separate driver. Monitoring and modeling such disease drivers can help anticipate future IDTEs and strengthen control measures. More important, intervening directly on these underlying drivers can diminish the likelihood of the occurrence of an IDTE and reduce the associated human and economic costs.

  • 26. Sendi, Parham
    et al.
    Johansson, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Biomedicinsk laboratorievetenskap.
    Dahesh, Samira
    Van-Sorge, Nina M
    Darenberg, Jessica
    Norgren, Mari
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Biomedicinsk laboratorievetenskap.
    Sjölin, Jan
    Nizet, Victor
    Norrby-Teglund, Anna
    Bacterial phenotype variants in group B streptococcal toxic shock syndrome.2009Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 15, nr 2, s. 223-232Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We conducted genetic and functional analyses of isolates from a patient with group B streptococcal (GBS) necrotizing fasciitis and toxic shock syndrome. Tissue cultures simultaneously showed colonies with high hemolysis (HH) and low hemolysis (LH). Conversely, the HH and LH variants exhibited low capsule (LC) and high capsule (HC) expression, respectively. Molecular analysis demonstrated that the 2 GBS variants were of the same clonal origin. Genetic analysis found a 3-bp deletion in the covR gene of the HH/LC variant. Functionally, this isolate was associated with an increased growth rate in vitro and with higher interleukin-8 induction. However, in whole blood, opsonophagocytic and intracellular killing assays, the LH/HC phenotype demonstrated higher resistance to host phagocytic killing. In a murine model, LH/HC resulted in higher levels of bacteremia and increased host mortality rate. These findings demonstrate differences in GBS isolates of the same clonal origin but varying phenotypes.

  • 27.
    Svensson, Kerstin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Bäck, Erik
    Örebro Universitetssjukhus.
    Eliasson, Henrik
    Örebro Universitetssjukhus.
    Berglund, Lennart
    Granberg, Malin
    Karlsson, Linda
    Swedish Defense Research Agency, Umea, Sweden.
    Larsson, Pär
    Swedish Defense Research Agency, Umea, Sweden.
    Forsman, Mats
    Swedish Defense Research Agency, Umea, Sweden.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk bakteriologi.
    Landscape epidemiology of tularemia outbreaks in Sweden2009Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 15, nr 12, s. 1937-1947Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Summer outbreaks of tularemia that occurred from 1995 through 2005 in 2 locations in Sweden affected 441 persons. We performed an epidemiologic investigation of these outbreaks using a novel strategy, involving high-resolution genotyping of Francisella tularensis isolates obtained from 136 patients (using 18 genetic markers developed from 6 F. tularensis genome sequences) and interviews with the patients. Strong spatial associations were found between F. tularensis subpopulations and the places of disease transmission; infection by some subpopulations occurred within areas as small as 2 km(2), indicating unidentified environmental point sources of tularemia. In both locations, disease clusters were associated with recreational areas beside water, and genetic subpopulations were present throughout the tularemia season and persisted over years. High-resolution genotyping in combination with patients' statements about geographic places of disease transmission provided valuable indications of likely sources of infection and the causal genotypes during these tularemia outbreaks.

  • 28. Waldenström, Jonas
    et al.
    Lundkvist, Ake
    Falk, Kerstin I
    Garpmo, Ulf
    Bergström, Sven
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten).
    Lindegren, Gunnel
    Sjöstedt, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk bakteriologi.
    Mejlon, Hans
    Fransson, Thord
    Haemig, Paul D
    Olsen, Björn
    Migrating birds and tickborne encephalitis virus2007Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 13, nr 8, s. 1215-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    During spring and autumn 2001, we screened 13,260 migrating birds at Ottenby Bird Observatory, Sweden, and found 3.4% were infested with ticks. Four birds, each a different passerine species, carried tickborne encephalitis virus (TBEV)-infected ticks (Ixodes ricinus). Migrating birds may play a role in the geographic dispersal of TBEV-infected ticks.

  • 29. Wallensten, Anders
    et al.
    Munster, Vincent J
    Latorre-Margalef, Neus
    Brytting, Mia
    Elmberg, Johan
    Fouchier, Ron A M
    Fransson, Thord
    Haemig, Paul D
    Karlsson, Malin
    Lundkvist, Ake
    Osterhaus, Albert D M E
    Stervander, Martin
    Waldenström, Jonas
    Björn, Olsen
    Umeå universitet, Medicinsk fakultet, Klinisk mikrobiologi, Infektionssjukdomar.
    Surveillance of influenza A virus in migratory waterfowl in northern Europe.2007Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 13, nr 3, s. 404-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We conducted large-scale, systematic sampling of influenza type A virus in migratory waterfowl (mostly mallards [Anas platyrhynchos]) at Ottenby Bird Observatory, southeast Sweden. As with previous studies, we found a higher prevalence in fall than spring, and among juveniles compared with adults. However, in contrast to other studies, we found that prevalence in spring was sometimes high (mean 4.0%, highest 9.5%). This finding raises the possibility that ducks are capable of perpetuating influenza A virus of different subtypes and subtype combinations throughout the year and from 1 year to the next. Isolation of the H5 and H7 subtypes was common, which suggests risk for transmission to sensitive domestic animals such as poultry. We argue that wild bird screening can function as a sentinel system, and we give an example of how it could have been used to forecast a remote and deadly outbreak of influenza A in poultry.

  • 30.
    Widerström, Micael
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar. Jämtland Cty Council, Östersund, Sweden.
    Schönning, Caroline
    Lilja, Mikael
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Lebbad, Marianne
    Ljung, Thomas
    Allestam, Görel
    Ferm, Martin
    Björkholm, Britta
    Hansen, Anette
    Hiltula, Jan I.
    Långmark, Jonas
    Löfdahl, Margareta
    Omberg, Maria
    Reuterwall, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Samuelsson, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Widgren, Katarina
    Wallensten, Anders
    Lindh, Johan
    Large outbreak of cryptosporidium hominis infection transmitted through the public water supply, Sweden2014Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 20, nr 4, s. 581-589Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In November 2010, approximate to 27,000 (approximate to 45%) inhabitants of Östersund, Sweden, were affected by a waterborne outbreak of cryptosporidiosis. The outbreak was characterized by a rapid onset and high attack rate, especially among young and middle-aged persons. Young age, number of infected family members, amount of water consumed daily, and gluten intolerance were identified as risk factors for acquiring cryptosporidiosis. Also, chronic intestinal disease and young age were significantly associated with prolonged diarrhea. Identification of Ctyptosporidium hominis subtype lbA10G2 in human and environmental samples and consistently low numbers of oocysts in drinking water confirmed insufficient reduction of parasites by the municipal water treatment plant. The current outbreak shows that use of inadequate microbial barriers at water treatment plants can have serious consequences for public health. This risk can be minimized by optimizing control of raw water quality and employing multiple barriers that remove or inactivate all groups of pathogens.

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