States ate raw pork while traveling in the Philippines (23)before the infection.Skin injury was shown for one fourth of case-patients,and alcohol use was evident in approximately one third ofcase-patients. However, a case–control study in Vietnamdid not identify alcohol use as an independent risk factorafter adjustment for other risk factors and confounders (6).The most commonly reported preexisting condition wasdiabetes. Other conditions included underlying heart disease, hypertension, cirrhosis, and cancer (online TechnicalAppendix Table 3). Smoking was mentioned in 5.2% ofpatients in the single-case dataset.