A widespread epidemic of Zika virus (ZIKV) infection was reported in 2015 in South and Central America and the Caribbean. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with ZIKV. In this report, we describe the case of an expectant mother who had a febrile illness with rash at the end of the first trimester of pregnancy while she was living in Brazil. Ultrasonography performed at 29 weeks of gestation revealed microcephaly with calcifications in the fetal brain and placenta. After the mother requested termination of the pregnancy, a fetal autopsy was performed. Micrencephaly (an abnormally small brain) was observed, with almost complete agyria, hydrocephalus, and multifocal dystrophic calcifications in the cortex and subcortical white matter, with associated cortical displacement and mild focal inflammation. ZIKV was found in the fetal brain tissue on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay, with consistent findings on electron microscopy. The complete genome of ZIKV was recovered from the fetal brain.

Anaplasma phagocytophilum is a Gram-negative, tick-transmitted, obligate intracellular bacterium that elicits acute febrile diseases in humans and domestic animals. In contrast to the United States, human granulocytic anaplasmosis seems to be a rare disease in Europe despite the initial recognition of A. phagocytophilum as the causative agent of tick-borne fever in European sheep and cattle. Considerable strain variation has been suggested to occur within this species, because isolates from humans and animals differed in their pathogenicity for heterologous hosts. In order to explain host preference and epidemiological diversity, molecular characterization of A. phagocytophilum strains has been undertaken. Most often the 16S rRNA gene was used, but it might be not informative enough to delineate distinct genotypes of A. phagocytophilum. Previously, we have shown that A. phagocytophilum strains infecting Ixodes ricinus ticks are highly diverse in their ankA genes. Therefore, we sequenced the 16S rRNA and ankA genes of 194 A. phagocytophilum strains from humans and several animal species. Whereas the phylogenetic analysis using 16S rRNA gene sequences was not meaningful, we showed that distinct host species correlate with A. phagocytophilum ankA gene clusters.

19Laboratories are currently witnessing extraordinary demand globally for sampling devices, 20 reagents, consumables, and diagnostic instruments needed for timely diagnosis of SARS-CoV-2 21 infection. To meet diagnostic needs as the pandemic grows, the US Food and Drug 22 Administration (FDA) recently granted several commercial SARS-CoV-2 tests Emergency Use 23 Authorization (EUA), but manufacturer-independent evaluation data are scarce. We performed 24 the first manufacturer-independent evaluation of the fully automated sample-to-result two-25 target test cobas 6800 SARS-CoV-2 (cobas) (Roche Molecular Systems, Branchburg, NJ), which 26 received US FDA EUA on March 12, 2020. The comparator was a standardized 3-hour SARS-CoV-27 2 protocol, consisting of RNA extraction using an automated portable instrument, followed by a 28 two-target RT-PCR, which our laboratory has routinely used since January 2020 (Corman VM et 29 al. EuroSurveill 25(3):2000045). Cobas and the comparator showed overall agreement of 98.1% 30 and a kappa value of 0.95 on an in-house validation panel consisting of 217 well-characterized 31 retrospective samples. Immediate prospective head-to-head comparative evaluation followed 32 on 502 samples, and the diagnostic approaches showed overall percent agreement of 99.6% 33 and a kappa value of 0.98. A good correlation (r² = 0.96) between cycle threshold values for 34 SARS-CoV-2 specific targets obtained by cobas and the comparator was observed. Our results 35 showed that cobas is a reliable assay for qualitative detection of SARS-CoV-2 in nasopharyngeal 36 swab samples collected in the UTM-RT system. Under the extraordinary circumstances that 37 laboratories are facing worldwide, a safe diagnostic platform switch is feasible in only 48 hours 38 and in the midst of the COVID-19 pandemic if carefully planned and executed. 39 on June 9, 2020 by guest http://jcm.asm.org/ Downloaded from 3 40 Keywords: SARS-CoV-2, COVID-19, cobas, cobas 6800 41 on June 9, 2020 by guest http://jcm.asm.org/ Downloaded from 58 12), followed by the launch of a range of commercial SARS-CoV-2 PCR-based assays in the last 3 59 months. Despite the fact that the US Food and Drug Administration (FDA) granted several 60 commercial SARS-CoV-2 amplification assays Emergency Use Authorization (EUA), as of March 61 29, 2020 no manufacturer-independent evaluation data for any commercial SARS-CoV-2 assay 62 with US FDA EUA is available in peer-reviewed literature. 63 on June 9, 2020 by guest http://jcm.asm.org/ Downloaded from 5 Here we present the results of the first manufacturer-independent evaluation of the fully 64 automated sample-to-result two-target test cobas 6800 SARS-CoV-2 (cobas) (Roche Molecular 65 Systems, Branchburg, NJ, USA), which received US FDA EUA on March 12, 2020. The 66 performance of cobas was first evaluated on a well-characterized in-house validation panel 67 consisting of 217 samples. The comparator was a standardized 3-hour SARS-CoV-2 detection 68 protocol, consisting of RNA extraction using an automated por...

Human granulocytic ehrlichiosis (HGE) was recently described in North America. It is caused by an Ehrlichia species closely related to Ehrlichia phagocytophila and Ehrlichia equi, recognized to infect mostly ruminants and horses, respectively. The vector in North America is the tick Ixodes scapularis, which is also the vector of the Lyme disease agent, Borrelia burgdorferi. Previous serologic studies in patients with a diagnosis of Lyme borreliosis indicate that HGE may exist in Europe. We report the first documented case of HGE in Europe. The diagnosis was established by seroconversion to E. equi and the HGE agent and by PCR with sequence analysis of the gene encoding the HGE agent 16S rRNA. Interestingly, the patient presented with a self-limited but moderately severe illness. Thus, European physicians need to be aware that HGE exists in Europe and that the diagnosis should be considered in febrile patients with tick bites in areas where Lyme disease is endemic.

We describe cervids as potential reservoir hosts of Babesia EU1 and B. divergens . Both babesial parasites were found in roe deer. Sequence analysis of 18S rRNA showed 99.7% identity of roe deer Babesia EU1 with the human EU1 strain. B. divergens detected in cervids was 99.6% identical to bovine B. divergens .