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Recurrent Bordetella holmesii Bacteremia and Nasal Carriage in a Patient Receiving Rituximab

Centers for Disease Control and Prevention
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DOI: 10.3201/eid1910.130345
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LETTERS were seropositive. Because antibod- ies may be detectable 10 days–3 weeks after experimental infection for the first time (8), the presumed period of infection was between mid- January and mid-February. At this time, the highest temperatures again rose above 6°C for a few days (Figure 1, panel A). Although the within-herd sero- prevalence was >90% in ewes after confirmed or suspected SBV infection in 2011 (9), in this study, conducted during the cold season, only 12 (13%) of 90 tested sheep were positive by ELISA. Three animals seroconverted between mid-January and mid-Febru- ary. Thus, SBV transmission appears to be possible at a low level, most like- ly because of the low activity of the involved insect vectors. In addition to the SBV cases found on the sheep holding in Meck- lenburg–Western Pomerania, an ad- ditional 52 confirmed SBV cases (defined as virus detection by qRT- PCR or isolation in cell culture) in adult ruminants were reported to the German Animal Disease Report- ing System from January 1 through February 20, 2013 (Figure, panel B). Most affected animal holdings were located in Bavaria, but cases were also reported from Thuringia, Saxony, Brandenburg, Mecklen- burg–Western Pomerania, Hesse, and Lower Saxony. In conclusion, trans- mission of SBV by hematophagous insects seems possible, even dur- ing the winter in central Europe, if minimum temperatures rise above a certain threshold for several consecu- tive days. Acknowledgments We are grateful to Anja Landmesser for excellent technical assistance. This study was supported by the Germany Federal Ministry of Food, Agri- culture and Consumer Protection and the European Union as outlined in Council Decision 2012/349/EU. Kerstin Wernike, Mareen Kohn, Franz J. Conraths, Doreen Werner, Daniela Kameke, Silke Hechinger, Helge Kampen, and Martin Beer Author affiliations: Friedrich-Loeffler-Institut, Insel Riems, Germany (K. Wernike, M. Kohn, D. Kameke, S. Hechinger,

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