Staphylococcus aureus, vancomycin-resistant

Contact with infected person.

First emerged in U.S. in 2002; consequence of intensive use of antimicrobials; can be spread from patient to patient in health care settings; risk of spread into the community.

Protozoa

Cryptosporidiosis

(Cryptosporidium parvum)

Fecal–oral spread; may be food or water borne.

Massive outbreak in Milwaukee in 1993 (estimated >400,000 cases) linked to contamination of municipal water supply; oocysts are resistant to chlorine and other chemicals used to purify drinking water; infection may be severe in persons with AIDS or otherwise immunocompromised because of drugs or disease.

Cyclospora

(Cyclospora cayetanensis)

Ingestion of contaminated food or water.

Multiple outbreaks in North America in 1990s linked to imported raspberries from Guatemala; endemic in many countries.

Malaria

Bite of infective mosquito.

Increasing morbidity and mortality in many areas, especially in Africa; increase linked to poor vector control and rising resistance to inexpensive antimalarial drugs, lack of resources for other drugs and other control measures.

Viruses

Dengue fever (and dengue hemorrhagic fever and shock syndrome); dengue viruses, serotypes 1,2,3,4

Bite of infective mosquito, usually Aedes aegypti.

Found in most tropical and subtropical areas worldwide, including urban areas; outbreak in Hawaii in 2001–2002; epidemics are increasing in size and severity, especially in Asia and Latin America; factors in worsening situation include poor mosquito control, abundant mosquito breeding sites in growing tropical cities, travel of humans who carry the virus, and wide circulation of more than one serotype of virus.



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