Table of Contents EMERGING INFECTIOUS DISEASES Volume 2, Number 2, April-June 1996 Perspectives * Globalization, International Law, and Emerging Infectious Diseases, David P. Fidler * On Epidemiology and Geographic Information Systems: A Review and Discussion of Future Directions, Keith C. Clarke, Sara L. McLafferty, and Barbara J. Tempalski * The Evolution and Maintenance of Virulence in Microparasites, Bruce R. Levin * The Infectious Diseases Impact Statement: A Mechanism for Addressing Emerging Infectious Diseases, Edward McSweegan Synopsis * Emerging Disease Issues and Fungal Pathogens Associated with HIV Infection, Neil M. Ampel Dispatches * An Outbreak of Ross River Virus Disease in Southwestern Australia, Michael Lindsay, Nidia Oliveira, Eva Jasinska, Cheryl Johansen, Sue Harrington, A.E Wright, and David Smith * Invasive Penicillin-Resistant Pneumococcal Infections: A Prevalence and Historical Cohort Study, Crystal B. Kronenberger, Richard E. Hoffman, Dennis C. Lezotte, and William M. Marine * Nosocomial Transmission of Multidrug-Resistant Mycobacterium tuberculosis in Spain, John V. Rullán, Dionisio Herrera, Rosa Cano, Victoria Moreno, Pere Godoy, Enrique F. Peiró, Juan Castell, Consuelo Ibañez, Arturo Ortega, Leopoldo Sánchez Agudo, and Francisco Pozo * Application of Pulsed-Field Gel Electrophoresis to an International Outbreak of Salmonella agona, E. John Threlfall, Michael D. Hampton, Linda R. Ward, and Bernard Rowe * Potential Risk for Dengue Hemorrhagic Fever: The Isolation of Serotype Dengue-3 in Mexico, Baltasar Briseño-García, Héctor Gómez-Dantés, Enid Argott-Ramírez, RaulMontesano, Ana-Laura Vázquez-Martínez, Sergio Ibáñez-Bernal, Guillermina Madrigal-Ayala, Cuauhtémoc Ruíz-Matus, Ana Flisser, and Roberto Tapia-Conyer * Improved Serodiagnostic Testing for Lyme Disease: Results of a Multicenter Serologic Evaluation, Robert B. Craven, Thomas J. Quan, Raymond E. Bailey, Raymond Dattwyler, Raymond W. Ryan, Leonard H. Sigal, Allen C. Steere, Bradley Sullivan, Barbara J.B. Johnson, David T. Dennis, and Duane J. Gubler * Emergence of Bartonella quintana Infection among Homeless Persons, Lisa A. Jackson, and David H. Spach * The Reemergence of Visceral Leishmaniasis in Brazil, Jorge R. Arias, Pedro S. Monteiro, and Fabio Zicker Commentary * Molecular Epidemiology of Pneumocystis carinii Pneumonia, Charles B. Beard and Thomas R. Navin * Needed: Comprehensive Response to the Spread of Infectious Diseases, Harold M. Ginzburg Letters * Transfusion-Associated Malaria, Frances Taylor * Reply to F. Taylor, Jane R. Zucker and S. Patrick Kachur * An Outbreak of Hemolytic Uremic Syndrome due to Escherichia coli O157:H-: Or Was It? P. N. Goldwater and K. A. Bettelheim * The Dilemma of Xenotransplantation, Claude E. Chastel * The Thucydides Syndrome: Ebola Déjà Vu? (Or Ebola Reemergent?) P. E. Olson, C. S. Hames, A. S. Benenson, and E. N. Genovese News and Notes * BSE Meeting at CDC * CDC Foundation Supports Emerging Infectious Disease Projects, Charlie Stokes 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, Bethesda, Maryland, USA Dispatches Editor Stephen Ostroff, M.D., National Center for Infectious Diseases, 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 Liaison Representatives Anthony I. Adams, M.D., Chief Medical Adviser, Commonwealth Department of Human Services and Health, Canberra, Australia David Brandling-Bennett, M.D., Director, Division of Communicable Diseases, 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, 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. Dept. 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 Phillip 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 Epidemiología Dirección General de Epidemiología Secretaría de Salud México 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.S. Electronic Distribution Carol Y. Crawford David L. Smith Cheryl G. Shapiro, M.S. 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 materials published in Emerging Infectious Diseases are 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. 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 Editorial Material: 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). 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. Dispatches (1,000 to 1,500 words of text) should be in a letter to the editor format and should not be divided into sections. Dispatches should begin with a brief introductory statement about the relationship of the topic to the emergence of infectious diseases. Provide references, not to exceed 10, and figures or illustrations, not to exceed two. 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.