Pathologic Studies on Suspect Animal and Human Cases of Rift Valley Fever from an Outbreak in Eastern Africa, 2006–2007

Wun-Ju Shieh Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Chris D. Paddock Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Edith Lederman Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Carol Y. Rao Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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L. Hannah Gould Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Mohamed Mohamed Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Fausta Mosha Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Janeth Mghamba Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Peter Bloland Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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M. Kariuki Njenga Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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David Mutonga Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Amwayi A. Samuel Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Jeannette Guarner Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Robert F. Breiman Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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Sherif R. Zaki Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Mycotics Diseases Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Hospital Services Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya

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DOI:
https://doi.org/10.4269/ajtmh.2010.09-0463
Volume/Issue:
Volume 83: Issue 2_Suppl
Page(s):
38–42
Restricted access
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Rift Valley fever (RVF) is an important viral zoonotic disease in Africa with periodic outbreaks associated with severe disease, death, and economic hardship. During the 2006–2007 outbreaks in Eastern Africa, postmortem and necropsy tissue samples from 14 animals and 20 humans clinically suspected of RVF were studied with histopathologic evaluation and immunohistochemical (IHC) assays. Six animal and 11 human samples had IHC evidence of Rift Valley fever virus (RVFV) antigens. We found that extensive hepatocellular necrosis without prominent inflammatory cell infiltrates is the most distinctive histopathologic change in liver tissues infected with RVFV. Pathologic studies on postmortem tissue samples can help establish the diagnosis of RVF, differentiating from endemic diseases with clinical manifestations similar to RVF, such as malaria, leptospirosis, or yellow fever.

Author Notes

*Address correspondence to Wun-Ju Shieh, Infectious Diseases Pathology Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mail Stop G-32, Atlanta, GA 30333. E-mail: wshieh@cdc.gov

Authors' addresses: Wun-Ju Shieh, Chris D. Paddock, and Sherif R. Zaki, Infectious Disease Pathology Branch, Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: wshieh@cdc.gov, cdp9@cdc.gov, and sxz1@cdc.gov. Edith Lederman, Division of Infectious Diseases, Naval Medical Center, San Diego, CA, E-mail: Edith.Lederman@med.navy.mil. Carol Y. Rao, Prevention and Response Branch, Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases, Atlanta, GA, E-mail: cnr3@cdc.gov. L. Hannah Gould, Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: dvj9@cdc.gov. Mohamed Mohamed and Janeth Mghamba, Epidemiology Section, Preventive Department, Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania, E-mails: mahd67@yahoo.com and mashaka_2000@yahoo.com. Fausta Mosha, African Field Epidemiology Network, Tanzania Field Epidemiology and Laboratory Training Programme, Dar es Salaam, Tanzania, E-mail: fausta_mosha@yahoo.com. Peter Bloland, Office of the Director, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: pbb1@cdc.gov. M. Kariuki Njenga and Robert F. Breiman, International Emerging Infections Program, Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya, E-mails: knjenga@ke.cdc.gov and rbeiman@ke.cdc.gov. David Mutonga and Amwayi A. Samuel, Ministry of Public Health and Sanitation, Department of Disease Control and Prevention, Field Epidemiology and Laboratory Training Programme (FELTP), Nairobi, Kenya, E-mails: doctordavidm2000@yahoo.com and amwayi2004@yahoo.com. Jeannette Guarner, Department of Pathology and Laboratory Medicine at Emory University, Emory University School of Medicine, Emory University Hospital, Atlanta, GA, E-mail: jguarne@emory.edu.

Copyright:
Copyright © 2010 by The American Society of Tropical Medicine and Hygiene 2010
Received:
10 Aug 2009
|
Accepted:
04 Dec 2009
|
Published Online:
05 Aug 2010
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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