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Punctuation

Accents

Do not use accents for words that can be correct without them; e.g., naive, debride (not naïve, débride)

Apostrophes

Use an apostrophe to indicate possession. If the possessor is plural, the apostrophe comes after the plural –s.

the patient's symptoms
6 months' gestation
woolsorters' disease

Pronominal possessives (his, hers, yours, theirs, ours, its) do not take an apostrophe. (It's is a contraction of it is.)

Year indications are not possessive.

1960s not 1960's

Diseases, syndromes, tests, or compounds that are named after a person or place are not possessive. Official animal names, however, may retain apostrophes (see http://www.itis.gov/ for animal names).

Bright disease
Chagas disease
Down syndrome
Hodgkin disease
Kaposi sarcoma
Kawasaki syndrome
Lyme disease
Marfan syndrome
Minimata disease
Reye syndrome
Student t test
Bonferroni adjustment
Eagle minimal essential medium

Exceptions: Legionnaires' disease, woolsorters' disease

Avoid the following eponyms:

Reiter syndrome (use reactive arthritis)
Wegener's granulomatosis (use vasculitis or ANCA-associated granulomatous vasculitis)

Note: ANCA = antineutrophil cytoplasmic antibodies

Colons

A colon may be used, sparingly, to introduce a list or series. Do not capitalize the first word after a colon (unless it would be capitalized for other reasons, such as beginning a sentence or a subtitle). Do not use a colon to introduce a series of complete sentences; change the colon to a period or edit the list so that it is no longer made up of complete sentences.

Incorrect: Cells were prepared as follows: Strain 12B was grown in G broth. Cells were harvested by centrifugation. The pellet was dissolved in solution Y.
Correct: Cells were prepared as follows. Strain 12 B was grown in G broth. Cells were harvested by centrifugation. The pellet was dissolved in solution Y.
Correct: Cells were prepared as follows: strain 12B was grown in G broth, cells were harvested by centrifugation, and the pellet was dissolved in solution Y.

If any item in a list includes a complete sentence that gives information about that item only, either edit out the colon or put the additional information in parentheses.

Incorrect: This conclusion is based on the following results: 1) The mapping of the mutations between 0.13 and 0.23 map unit. This finding indicates that they lie within a 1.2-kbp region. 2) The presence of the Nif phenotype in all the mutants.

Correct: This conclusion is based on the following results: 1) the mapping of the mutations between 0.13 and 0.23 map unit (this indicates that they lie within a 1.2-kbp region) and 2) the presence of the Nif phenotype.

Do not use a colon if the items in the list complete the sentence grammatically.

Incorrect: XYZ medium contained: A, B, and C.
Correct: XYZ medium contained A, B, and C.

Commas

Commas are required in all of the following situations:

  • before the conjunction in a compound sentence if both clauses are independent.

    Incorrect: All culture results were negative for S. pneumoniae, and were omitted from multivariate analysis.
    Correct: All culture results were negative for S. pneumoniaeand were omitted from multivariate analysis.
    Correct: All culture results were negative for S. pneumoniae, and they were omitted from multivariate analysis.

  • after all items linked by and or or in a series, including the item before the conjunction.
  • after state when city is mentioned in text.

    in Dallas, Texas, in 1995

  • after date that gives month, day, and year in text.

    Comma needed: The test given January 1, 1997, showed that…
    Comma not needed: The test given in January 1997 showed that

  • after an introductory phrase of >5 words; a comma can be used after fewer words if necessary to clarify the meaning.
  • after i.e. and e.g.
  • in numerals >999 (e.g., 100,000)
See also Restrictive and Nonrestrictive Clauses.

Dashes

Avoid em-dashes (—) in scientific writing. Their use is for sudden breaks in thought that change the sentence structure or amplify and expand a phrase in the main clause. Try parentheses instead.

Use an en-dash (–) to connect numbers in a range. Use a hyphen, not an en dash, between numbers that are not inclusive (e.g., phone numbers and grant numbers).

Use an en-dash to indicate negative values (–70°C).

Use between compound adjectives when 1 element is an open compound, when >2 elements are hyphenated compounds, or in complex modifying phrases that include suffixes and prefixes and hyphens.

New York–Boston connector
Trypanosoma cruzi–infected
Triatoma infestans
Reverse transcription–PCR

In complex modifying phrases that include suffixes or prefixes, hyphens and en-dashes are sometimes used to avoid ambiguity.

non-group–specific blood
manic-depressive–like symptoms

Hyphens

Terms formed by combining >2 words or elements of words may be open (with a space between them), hyphenated, or solid (as 1 word). If in doubt about how to treat a compound, consult Merriam-Webster's or Dorland's dictionaries. Below is a list of common terms.

acute-phase serum samples

age group (2 words)

airborne

 

antibody-capture ELISA

antibody-positive children

Antimicrobial drug-resistant [noun] Antimicrobial drug resistance

basepair

 

bed net (n), bed-net (adj)

bedbug

birthweight

blood-borne

breast-feed, breast-fed

case-patient, control-patient/participant

chickenpox

child care (n), childcare (adj)

childbearing

ClustalW

co-infection

co-trimoxazole

co-worker

 

cut off (v), cutoff (adj)

database, dataset

day care (n), daycare (adj)

email

Epi Info

Etest

fingerstick

follow-up (n), follow up (v)

foodborne

foot-and-mouth disease

fresh water (n), freshwater (adj)

groundwater

hand, foot, and mouth disease

handwashing

healthcare

Insect-borne

life cycle

 

live-born

long term (n), long-term (adj)

longstanding

managed care (n, adj)

maximum-likelihood (as adj only)

maximum-parsimony (as adj only)

needlestick

neighbor-joining (as adj only)

 

plaque-reduction neutralization test

postmortem

postpartum

pulsed-field gel electrophoresis

 

real-time reverse transcription–PCR

reemerge

restriction fragment length polymorphism

 

Robert Koch Institute (not Koch-Institute)

sandfly

short term (n), short-term (adj)

ST5 (no hyphen with sequence types)

stand by (v), standby (adj)  

T cell (n), T-cell (adj)

tick-borne

under way

USA300

variable number tandem repeat

 

vector-borne

 

waterborne

website, Web page

well-being

well-known person, but he is well known

work-up (n), work up (v)

worldwide

 

 

Common and unambiguous compound adjectives need not be hyphenated. Ethnic designations are never hyphenated, even when used adjectivally.

food safety issues, foodborne illness study, public health nurse
African American patients, French Canadian ancestry, Asian American participants

Prefixes

Below is a list of common prefixes. They should always be solid except as noted below.

ante

inter

over

sub

anti

intra

post

super

co

macro

pre

supra

counter

micro

pro

trans

de

mid

pseudo

ultra

extra

multi

re

un

infra

non

semi

Exceptions:

  • before a capital letter (un-American, sub-Saharan)
  • before an abbreviation or acronym (non-mRNA)
  • before a numeral (pre-1970)
  • to avoid confusion with a similar unhyphenated word (re-cover, re-creation)
  • to avoid a confusing meaning, as in immunologic terms such as anti-rabbit, anti-goat, anti-mouse, anti-human. Goat anti-rabbit IgG means goat antiserum against rabbit IgG, not goat IgG that is antirabbit.

Even if letters are doubled, common prefixes are usually not joined by hyphens.

antiinflammatory
intraabdominal
nonnegotiable
posttraumatic

Always hyphenate the prefixes self- and cross-.

self-aware, self-sticking, cross-react

Suffixes

Similarly, most common suffixes are joined without a hyphen, such as -fold, -hood, -less, -like, -wide, and -wise, unless doing so creates an unclear or excessively long word, triples a consonant (bell-like), follows a proper noun (Whitman-like), or follows a number (10-fold, 2.5-fold).

Exception: Hyphenate –like for words with >1 syllable, unless the word ends with L.

Doglike
Canine-like
Bell-like

Hyphenate all words with the –borne suffix.  Exceptions are those listed in Merriam-Webster dictionary as 1 word (airborne, foodborne, waterborne).

For words with a prefix that modifies a hyphenated term, use hyphen for primary construction and en-dash for secondary construction. In the following example, non- modifies mosquito-borne, not just mosquito so the en-dash is used.

Non–mosquito-borne, not nonmosquito-borne

Do not hyphenate after an adverb ending in –ly, even when used in a compound modifier preceding the word modified.

The rapidly rising temperature caused…

Do not hyphenate foreign phrases that are printed open in other circumstances (e.g., in vitro translation, in situ protein synthesis, in vitro–stimulated growth, in situ–synthesized proteins).

Do not hyphenate CDC mailstops.

Mailstop C12

Parentheses and Brackets

Nested parentheses sometimes appear in chemical names, usage is dependent on the author's discretion as to how to best use them.

(x(yy)x)

If a designation that already contains parentheses must be enclosed within parentheses, do not change the designation. Instead, use brackets in place of the outer set of parentheses.

Incorrect: another strain (strain 123[pXYZ])
Incorrect: another strain (strain 123(pXYZ))
Correct: another strain [strain 123(pXYZ)]

If a reference falls inside a parenthetical statement, separate it from other material with a semicolon. Do not enclose the reference number in brackets.

The procedure we used (the Lowry method; 12)…
(21; Table 1)

When multiple tables or figures are enclosed within the same parentheses, use commas, not the word and.

(Tables 1, 2), ­not (Tables 1 and 2)
(Table 3, Figure 2), not (Table 3 and Figure 2)

Exception: use a semicolon between print and online tables and figures (with or without URL) or between figure panels and another graphic (figure or table).

(Table 3; online Appendix Figure 2)
(Figure 3, panel B; Table 4)

Avoid numbered lists if possible. If a numbered list is necessary for clarity, use a single parenthesis to avoid confusion with references. Separate elements with commas, unless commas are used within elements, in which case semicolons should be used.

Three procedures were instituted hospitalwide: 1) handwashing, which is associated with fewer nosocomial infections; 2) isolation precautions, according to established guidelines; and 3) mandatory screening of staff.

Periods

Periods are omitted from some abbreviations…

US citizens
Washington, DC
Dr Tannenbaum
PhD

…but not others.

et al.
e.g., i.e.
Joseph E. Filmore
S. aureus
St. Louis

Email addresses or URLs in references are not followed by a period.

For an ellipsis, use the Microsoft Word character (…) rather than 3 periods separated by spaces.

Use a period for a decimal (23.7), not a comma (European style).

Semicolons

Semicolons are used to separate 2 independent clauses when no conjunction is used.

Guadalupe is a young community; 81% of houses were built in the past 20 years.
but
Guadalupe is a young community, and 81% of houses were built in the past 20 years.

Semicolons are also used to separate items in a series if internal punctuation is present.

Exclusion criteria included tobacco use; history of asthma, COPD, or lung cancer; pregnancy or intent to become pregnant; and inability to give informed consent.

Virgules

Use of a virgule implies duality.

The physician/patient experience implies that the physician and patient are one and the same.

The physician–patient relationship implies 2 different persons.

Correct: HIV/TB co-infection (because they equally describe the co-infection)
Avoid: HIV/AIDS (because they are not the same)

He or she, not he/she

Father and son bowling league, not father/son bowling league

Avoid and/or; most of the time simply and or or is appropriate.

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Additional Information:

Formatting Tables: Footnotes
Grammar: Restrictive and Nonrestrictive Clauses

 

Comments to the EID Editors

Please contact the EID Editors at eideditor@cdc.gov

The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

This page posted January 29, 2009
This page last reviewed August 12, 2009

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