EMERGING INFECTIOUS DISEASES, VOLUME 2, NUMBER 1 Editors Editor Joseph E. McDade, Ph.D. National Center for Infectious Diseases Centers for Disease Control and Prevention (CDC) Atlanta, Georgia, USA Perspectives Editor Stephen S. Morse, Ph.D. The Rockefeller University New York, New York, USA Synopses Editor Phillip J. Baker, Ph.D. Division of Microbiology and Infectious Diseases National Institute of Allergy and Infectious Diseases National Institutes of Health (NIH) Bethesda, Maryland, USA Dispatches Editor Stephen Ostroff, M.D. National Center for Infectious Diseases Centers for Disease Control and Prevention (CDC) Atlanta, Georgia, USA Managing Editor Polyxeni Potter, M.A. National Center for Infectious Diseases Centers for Disease Control and Prevention (CDC) Atlanta, Georgia, USA Editorial and Computer Support Emerging Infectious Diseases receives editorial and computer support from the Office of Planning and Health Communication, National Center for Infectious Diseases. Editorial Support Maria T. Brito Anne D. Mather, M.A. Carol D. Snarey, M.A. Production Rita M. Furman, M.A. Electronic Distribution Carol Y. Crawford Cheryl G. Shapiro, M.S. Liaison Representatives Anthony I. Adams, M.D. Chief Medical Adviser Commonwealth Department of Human Services and Health Canberra, Australia David Brandling-Bennett, M.D. Deputy Director Pan American Health Organization World Health Organization Washington, D.C., USA Gail Cassell, Ph.D. Liaison to American Society for Microbiology University of Alabama at Birmingham Birmingham, Alabama, USA Richard A. Goodman, M.D., M.P.H. Editor, MMWR Centers for Disease Control and Prevention (CDC) Atlanta, Georgia, USA William Hueston, D.V.M., Ph.D Acting Leader, Center for Animal Health Monitoring Centers for Epidemiology and Animal Health Veterinary Services, Animal and Plant Health Inspection Service U.S. Department of Agriculture Fort Collins, Colorado, USA James LeDuc, Ph.D. Advisor for Arboviral Diseases Division of Communicable Diseases World Health Organization Geneva, Switzerland Joseph Losos, M.D. Director General Laboratory Center for Disease Control Ontario, Canada Gerald L. Mandell, M.D. Liaison to Infectious Diseases Society of America University of Virginia Medical Center Charlottesville, Virginia, USA Philip P. Mortimer, M.D. Director, Virus Reference Division Central Public Health Laboratory London, United Kingdom Robert Shope, M.D. Director, Yale Arbovirus Research Unit Yale University School of Medicine New Haven, Connecticut, USA Natalya B. Sipachova, M.D., Ph.D. Scientific Editor Russian Republic Information & Analytic Centre Moscow, Russia Bonnie Smoak, M.D. Chief, Dept of Epidemiology Division of Preventive Medicine Walter Reed Army Institute of Research Washington, D.C., USA Robert Swanepoel, B.V.Sc., Ph.D. Head, Special Pathogens Unit National Institute for Virology Sandrinham 2131, South Africa Roberto Tapia, M.D. Director General de Epidemiolog¡a Direcci¢n General de Epidemiolog¡a Secretar¡a de Salud M‚xico Emerging Infectious Diseases Emerging Infectious Diseases is published four times a year by the National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road., Mailstop C-12, Atlanta, GA 30333, USA. Telephone 404-639-3967, fax 404-639-3039, e-mail eideditor@cidod1.em.cdc.gov. The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of CDC or the institutions with which the authors are affiliated. All material published in Emerging Infectious Diseases is in the public domain and may be used and reprinted without special permission; proper citation, however, is appreciated. 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 and Human Services. Electronic Access to Emerging Infectious Diseases If you have Internet access, you can retrieve the journal electronically through file transfer protocol (FTP), electronic mail, or World-Wide Web (WWW). The journal is available in three file formats: ASCII, Adobe Acrobat (.pdf), and PostScript (.ps). The ASCII version of the journal does not contain figures. Both the .pdf and .ps files, however, contain graphics and figures and are true representations of the hard copy of the journal. The Adobe Acrobat format requires an Adobe Reader. This reader is available in DOS, Windows, UNIX, and Macintosh versions. 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EID-PS sends the journal in PostScript format. However, because of the large file sizes and the complexity of sending the journal to different e-mail systems, it is strongly recommended that if you have FTP capabilities, you choose to access EID through FTP rather than by e-mail lists. To subscribe to a list, send an e-mail to lists@list.cdc.gov with the following in the body of your message: subscribe listname (e.g., subscribe EID-ASCII). Once you have requested a subscription, you will receive further instructions by e-mail. For more information about receiving Emerging Infectious Diseases electronically, send an e-mail to eidhelp@cidod1.em.cdc.gov. Instructions to Authors Editorial Policy and Call for Articles The goals of Emerging Infectious Diseases (EID) are to promote the recognition of new and reemerging infectious diseases and to improve the understanding of factors involved in disease emergence, prevention, and elimination. EID has an international scope and is intended for professionals in infectious diseases and related sciences. We welcome contributions from infectious disease specialists in academia, industry, clinical practice, and public health as well as from specialists in economics, demography, sociology, and other disciplines whose study elucidates the factors influencing the emergence of infectious diseases. EID will be published in English and will feature three types of articles: Perspectives, Synopses, and Dispatches. The purpose and requirements of each type of article are described in detail below. Instructions to Authors Manuscripts should be prepared according to the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" (JAMA 1993:269[17]: 2282-6). Begin each of the following sections on a new page and in this order: title page, abstract, text, acknowledgments, references, each table, figure legends, and figures. On the title page, give complete information about each author (full names and highest degree). Give current mailing address for correspondence (include fax number and e-mail address). Follow Uniform Requirements style for references. Consult List of Journals Indexed in Index Medicus for accepted journal abbreviations. Tables and figures should be numbered separately (each beginning with 1) in the order of mention in the text. Double-space everything, including the title page, abstract, references, tables, and figure legends. Italicize scientific names of organisms from species name all the way up, except for vernacular names (viruses that have not really been speciated, such as coxsackievirus and hepatitis B; bacterial organisms, such as pseudomonads, salmonellae, and brucellae). All articles will be reviewed by independent reviewers. The Editor reserves the right to edit articles for clarity and to modify the format to fit the publication style of Emerging Infectious Diseases. Documents sent in hardcopy should also be sent on diskette, or by e-mail. Acceptable electronic formats for text are ASCII, WordPerfect, AmiPro, DisplayWrite, MS Word, MultiMate, Office Writer, WordStar, or Xywrite. Send graphics documents in Corel Draw, Harvard Graphics, Freelance, .TIF (TIFF), .GIF (CompuServe), .WMF (Windows Metafile), .EPS (Encapsulated Postscript), or .CGM (Computer Graphics Metafile). The preferred font for graphics files is Helvetica. If possible, convert Macintosh files into one of the suggested formats. Submit photographs in glossy, camera-ready photographic prints. Send all manuscripts and correspondence to the Editor, Emerging Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop C-12, Atlanta, GA 30333, USA, or by e-mail on the Internet to eideditor@cidod1.em.cdc.gov. Perspectives: Contributions to the Perspectives section should provide insightful analysis and commentary about new and reemerging infectious diseases or related issues. Perspectives may also address factors known to influence the emergence of infectious diseases, including microbial adaption and change; human demographics and behavior; technology and industry; economic development and land use; international travel and commerce; and the breakdown of public health measures. Articles should be approximately 3,500 words and should include references, not to exceed 40. Use of additional subheadings in the main body of the text is recommended. If detailed methods are included, a separate section on experimental procedures should immediately follow the body of the text. Photographs and illustrations are optional. Provide a short abstract (150 words) and a brief biographical sketch. Synopses: Submit concise reviews of infectious diseases or closely related topics. Preference will be given to reviews of new and emerging diseases; however, timely updates of other diseases or topics are also welcome. Synopses should be approximately 3,500 words and should include references, not to exceed 40. Use of additional subheadings in the main body of the text is recommended. If detailed methods are included, a separate section on experimental procedures should immediately follow the body of the text. Photographs and illustrations are encouraged. Provide a short abstract (150 words) and a brief biographical sketch. Dispatches: Provide brief updates on trends in infectious diseases or infectious disease research. Include descriptions of new methods for detecting, characterizing, or subtyping emerging or reemerging pathogens. Developments in antimicrobioal drugs, vaccines, or infectious disease prevention or elimination programs are appropriate. Dispatches (1,000 to 1,500 words of text) should not be divided into sections. Provide references, not to exceed 10 and figures or illustrations, not to exceed two. Table of Contents EMERGING INFECTIOUS DISEASES Volume 2, Number 1, January-March 1996 Perspective * Molecular Population Genetic Analysis of Emerged Bacterial Pathogens: Selected Insights, James M. Musser Synopses * Emergence of the Ehrlichioses as Human Health Problems, David H. Walker, J. Stephen Dumler * Surveillance for Pneumonic Plague in the United States During an International Emergency: A Model for Control of Imported Emerging Diseases, Curtis L. Fritz, David T. Dennis, Margaret A. Tipple, Grant L. Campbell, Charles R. McCance, Duane J. Gubler * Changing Patterns of Autochthonous Malaria Transmission in the United States: A Review of Recent Outbreaks, Jane R. Zucker Dispatches * Cluster of Lyme Disease Cases at a Summer Camp in Kent County, Maryland, G. Thomas Strickland, Leena Trivedi, Stanley Watkins, Margaret Clothier, John Grant, John Morgan, Edward Schmidtman, Thomas Burkot * Unexplained Deaths Due to Possibly Infectious Causes in the United States: Defining the Problem and Designing Surveillance and Laboratory Approaches, Bradley A. Perkins, Jennifer M. Flood, Richard Danila, Robert C. Holman, Arthur L. Reingold, Laura A. Klug, Michael Virata, Paul R. Cieslak, Sherif R. Zaki, Robert W. Pinner, Rima F. Khabbaz, and the Unexplained Deaths Working Group * Trends in Bacteremic Infection Due to Streptococcus pyogenes (Group A Streptococcus), 1986-1995, Daniel M. Musher, Richard J. Hamill, Charles E. Wright, Jill E. Clarridge, Carol M. Ashton Letter * PHLS Surveillance of Antibiotic Resistance, England and Wales: Emerging Resistance in Streptococcus pneumoniae, David C. E. Speller, Alan P. Johnson, Barry D. Cookson, Pauline Waight, Robert C. George Commentary * Infectious Diseases in Latin America and the Caribbean: Are They Really Emerging and Increasing? A. David Brandling-Bennett, Francisco Pinheiro * Microbial Threats and the Global Society, Stuart B. Levy * Xenotransplantation: Risks, Clinical Potential, and Future Prospects, Robert E. Michler News and Notes * Another Human Case of Equine Morbillivirus Disease in Australia * Social Science and the Study of Emerging Infectious Diseases, Johannes Sommerfield, Sandra Lane * WHO Establishes New Rapid-Response Unit for Emerging Infectious Diseases, Philippe Stroot * Rotavirus Vaccine Workshop Held, Roger I. Glass * International Conference Addresses Preparedness for Emerging Strains of Pandemic Influenza, Dominick A. Iacuzio * Course Offered on Clinical and Pathologic Features of Emerging Infections, C. Robert Horsburgh, Jr. * NASA Sponsors Symposium on Remote Sensing and Control of Insect-Transmitted Diseases, Michael Braukus, Raj Khanna * CDC Convenes Meeting to Discuss Strategies for Preventing Invasive Group A Streptococcal Infections, The Working Group on Prevention of Severe Group A Streptococcal Infections * Regional Conference on Emerging Infectious Diseases Sparks Plan for Increased Collaboration, Bradford A. Kay