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Miko S, Collier SA, Burns-Lynch CE, Andújar AA, Benedict KM, Haston JC, Hough CO, Cope JR. (Mis)perception and Use of Unsterile Water in Home Medical Devices, PN View 360+ Survey, United States, August 2021 1. Emerg Infect Dis 2023; 29:397-401. [PMID: 36692441 PMCID: PMC9881759 DOI: 10.3201/eid2902.221205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Tap water is not sterile, and its use in home medical devices can result in infections from waterborne pathogens. However, many participants in a recent survey in the United States said tap water could safely be used for home medical devices. These results can inform communication materials to reduce the high consequence of infections.
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Prestel C, Moulton-Meissner H, Gable P, Stanton RA, Glowicz J, Franco L, McConnell M, Torres T, John D, Blackwell G, Yates R, Brown C, Reyes K, McAllister GA, Kunz J, Conners EE, Benedict KM, Kirby A, Mattioli M, Xu K, Gualandi N, Booth S, Novosad S, Arduino M, Halpin AL, Wells K, Walters MS. Dialysis Water Supply Faucet as Reservoir for Carbapenemase-Producing Pseudomonas aeruginosa. Emerg Infect Dis 2022; 28:2069-2073. [PMID: 36148936 PMCID: PMC9514332 DOI: 10.3201/eid2810.220731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
During June 2017-November 2019, a total 36 patients with carbapenem-resistant Pseudomonas aeruginosa harboring Verona-integron-encoded metallo-β-lactamase were identified in a city in western Texas, USA. A faucet contaminated with the organism, identified through environmental sampling, in a specialty care room was the likely source for infection in a subset of patients.
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Vanden Esschert K, Barrett CE, Collier SA, Garcia-Williams AG, Hannapel E, Yoder JS, Benedict KM. Demographic differences in use of household tap water in a representative sample of US adults, FallStyles 2019. J Water Health 2021; 19:1014-1020. [PMID: 34874907 PMCID: PMC9180987 DOI: 10.2166/wh.2021.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Tap water that is safe to consume may cause respiratory illness (e.g., Legionnaires' disease) when water conditions allow for proliferation and aerosolization of biofilm-associated pathogens. This study assessed household tap water consumption, exposure to aerosolized tap water, and associated demographics. A nationally representative FallStyles survey administered by Porter Novelli Public Services was sent to 4,677 US adult panelists in October 2019. There were 3,624 adults who completed the survey (77.5% response rate). Respondents were asked about self-reported use of household tap water for consumption (i.e., drinking, rinsing produce, or making ice) and use through water-aerosolizing devices (e.g., showerheads, humidifiers). Demographics included gender, age, race/ethnicity, education, income, region, and health status. Weighted analyses using complex sample survey procedures were used to assess tap water exposure by route and demographics. Most US adults are exposed to aerosolized tap water through showering (80.6%), and one in five are exposed through other water-aerosolizing devices (20.3%). Consumption and showering were greatest among older, White, higher educated, and higher-income adults. Aerosolized tap water can transmit waterborne pathogens and cause respiratory illness, especially among older age groups and people with weakened immune systems. These results will help target health messages for using water-aerosolizing devices safely.
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Affiliation(s)
- Kayla Vanden Esschert
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA E-mail:
| | - Catherine E Barrett
- Epidemiology and Statistics Branch, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Sarah A Collier
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA E-mail:
| | - Amanda G Garcia-Williams
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA E-mail:
| | - Elizabeth Hannapel
- Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Jonathan S Yoder
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA E-mail:
| | - Katharine M Benedict
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA E-mail:
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Collier SA, Deng L, Adam EA, Benedict KM, Beshearse EM, Blackstock AJ, Bruce BB, Derado G, Edens C, Fullerton KE, Gargano JW, Geissler AL, Hall AJ, Havelaar AH, Hill VR, Hoekstra RM, Reddy SC, Scallan E, Stokes EK, Yoder JS, Beach MJ. Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States. Emerg Infect Dis 2021; 27:140-149. [PMID: 33350905 PMCID: PMC7774540 DOI: 10.3201/eid2701.190676] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Provision of safe drinking water in the United States is a great public health achievement. However, new waterborne disease challenges have emerged (e.g., aging infrastructure, chlorine-tolerant and biofilm-related pathogens, increased recreational water use). Comprehensive estimates of the health burden for all water exposure routes (ingestion, contact, inhalation) and sources (drinking, recreational, environmental) are needed. We estimated total illnesses, emergency department (ED) visits, hospitalizations, deaths, and direct healthcare costs for 17 waterborne infectious diseases. About 7.15 million waterborne illnesses occur annually (95% credible interval [CrI] 3.88 million–12.0 million), results in 601,000 ED visits (95% CrI 364,000–866,000), 118,000 hospitalizations (95% CrI 86,800–150,000), and 6,630 deaths (95% CrI 4,520–8,870) and incurring US $3.33 billion (95% CrI 1.37 billion–8.77 billion) in direct healthcare costs. Otitis externa and norovirus infection were the most common illnesses. Most hospitalizations and deaths were caused by biofilm-associated pathogens (nontuberculous mycobacteria, Pseudomonas, Legionella), costing US $2.39 billion annually.
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Coffey CM, Collier SA, Gleason ME, Yoder JS, Kirk MD, Richardson AM, Fullerton KE, Benedict KM. Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995-2016. Clin Infect Dis 2021; 72:764-770. [PMID: 32047932 DOI: 10.1093/cid/ciaa128] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 02/07/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Giardiasis is the most common intestinal parasitic disease of humans identified in the United States (US) and an important waterborne disease. In the United States, giardiasis has been variably reportable since 1992 and was made a nationally notifiable disease in 2002. Our objective was to describe the epidemiology of US giardiasis cases from 1995 through 2016 using National Notifiable Diseases Surveillance System data. METHODS Negative binomial regression models were used to compare incidence rates by age group (0-4, 5-9, 10-19, 20-29, 30-39, 40-49, 50-64, and ≥ 65 years) during 3 time periods (1995-2001, 2002-2010, and 2011-2016). RESULTS During 1995-2016, the average number of reported cases was 19 781 per year (range, 14 623-27 778 cases). The annual incidence of reported giardiasis in the United States decreased across all age groups. This decrease differs by age group and sex and may reflect either changes in surveillance methods (eg, changes to case definitions or reporting practices) or changes in exposure. Incidence rates in males and older age groups did not decrease to the same extent as rates in females and children. CONCLUSIONS Trends suggest that differences in exposures by sex and age group are important to the epidemiology of giardiasis. Further investigation into the risk factors of populations with higher rates of giardiasis will support prevention and control efforts.
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Affiliation(s)
- Cushla M Coffey
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Sarah A Collier
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michelle E Gleason
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonathan S Yoder
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Martyn D Kirk
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Alice M Richardson
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Kathleen E Fullerton
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katharine M Benedict
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Beshearse E, Bruce BB, Nane GF, Cooke RM, Aspinall W, Hald T, Crim SM, Griffin PM, Fullerton KE, Collier SA, Benedict KM, Beach MJ, Hall AJ, Havelaar AH. Attribution of Illnesses Transmitted by Food and Water to Comprehensive Transmission Pathways Using Structured Expert Judgment, United States. Emerg Infect Dis 2021; 27:182-195. [PMID: 33350907 PMCID: PMC7774530 DOI: 10.3201/eid2701.200316] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Illnesses transmitted by food and water cause a major disease burden in the United States despite advancements in food safety, water treatment, and sanitation. We report estimates from a structured expert judgment study using 48 experts who applied Cooke's classical model of the proportion of disease attributable to 5 major transmission pathways (foodborne, waterborne, person-to-person, animal contact, and environmental) and 6 subpathways (food handler-related, under foodborne; recreational, drinking, and nonrecreational/nondrinking, under waterborne; and presumed person-to-person-associated and presumed animal contact-associated, under environmental). Estimates for 33 pathogens were elicited, including bacteria such as Salmonella enterica, Campylobacter spp., Legionella spp., and Pseudomonas spp.; protozoa such as Acanthamoeba spp., Cyclospora cayetanensis, and Naegleria fowleri; and viruses such as norovirus, rotavirus, and hepatitis A virus. The results highlight the importance of multiple pathways in the transmission of the included pathogens and can be used to guide prioritization of public health interventions.
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Mattioli MC, Benedict KM, Murphy J, Kahler A, Kline KE, Longenberger A, Mitchell PK, Watkins S, Berger P, Shanks OC, Barrett CE, Barclay L, Hall AJ, Hill V, Weltman A. Identifying septic pollution exposure routes during a waterborne norovirus outbreak - A new application for human-associated microbial source tracking qPCR. J Microbiol Methods 2020; 180:106091. [PMID: 33137355 DOI: 10.1016/j.mimet.2020.106091] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/13/2020] [Accepted: 10/27/2020] [Indexed: 11/18/2022]
Abstract
In June 2017, the Pennsylvania Department of Health (PADOH) was notified of multiple norovirus outbreaks associated with 179 ill individuals who attended separate events held at an outdoor venue and campground over a month period. Epidemiologic investigations were unable to identify a single exposure route and therefore unable to determine whether there was a persistent contamination source to target for exposure mitigation. Norovirus was detected in a fresh recreational water designated swimming area and a drinking water well. A hydrogeological site evaluation suggested a nearby septic leach field as a potential contamination source via ground water infiltration. Geological characterization revealed a steep dip of the bedrock beneath the septic leach field toward the well, providing a viral transport pathway in a geologic medium not previously documented as high risk for viral ground water contamination. The human-associated microbial source tracking (MST) genetic marker, HF183, was used as a microbial tracer to demonstrate the hydrogeological connection between the malfunctioning septic system, drinking water well, and recreational water area. Based on environmental investigation findings, venue management and local public health officials implemented a series of outbreak prevention strategies including discontinuing the use of the contaminated well, issuing a permit for a new drinking water well, increasing portable toilet and handwashing station availability, and promoting proper hand hygiene. Despite the outbreaks at the venue and evidence of ground water contamination impacting nearby recreational water and the drinking water well, no new norovirus cases were reported during a large event one week after implementing prevention practices. This investigation highlights a new application for human-associated MST methods to trace hydrological connections between multiple fecal pollutant exposure routes in an outbreak scenario. In turn, pollutant source information can be used to develop effective intervention practices to mitigate exposure and prevent future outbreaks associated with human fecal contaminated waters.
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Affiliation(s)
- Mia C Mattioli
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, USA.
| | - Katharine M Benedict
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, USA
| | - Jennifer Murphy
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, USA
| | - Amy Kahler
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, USA
| | - Kelly E Kline
- Pennsylvania Department of Health, Division of Infectious Disease Epidemiology, USA
| | - Allison Longenberger
- Pennsylvania Department of Health, Division of Infectious Disease Epidemiology, USA
| | - Patrick K Mitchell
- Pennsylvania Department of Health, Division of Infectious Disease Epidemiology, USA; Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sharon Watkins
- Pennsylvania Department of Health, Division of Infectious Disease Epidemiology, USA
| | - Philip Berger
- U.S. Environmental Protection Agency, Office of Ground Water and Drinking Water, Washington, DC, USA
| | - Orin C Shanks
- U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, OH, USA
| | - Catherine E Barrett
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, USA
| | - Leslie Barclay
- Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA
| | - Aron J Hall
- Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA
| | - Vincent Hill
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, USA
| | - Andre Weltman
- Pennsylvania Department of Health, Division of Infectious Disease Epidemiology, USA
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Barrett CE, Pape BJ, Benedict KM, Foster MA, Roberts VA, Rotert K, Mattioli MC, Yoder JS. Impact of Public Health Interventions on Drinking Water–Associated Outbreaks of Hepatitis A — United States, 1971–2017. MMWR Morb Mortal Wkly Rep 2019; 68:766-770. [DOI: 10.15585/mmwr.mm6835a4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Benedict KM, Collier SA, Marder EP, Hlavsa MC, Fullerton KE, Yoder JS. Case-case analyses of cryptosporidiosis and giardiasis using routine national surveillance data in the United States - 2005-2015. Epidemiol Infect 2019; 147:e178. [PMID: 31063098 PMCID: PMC6518830 DOI: 10.1017/s0950268819000645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Understanding endemic infectious disease risk factors through traditional epidemiological tools is challenging. Population-based case-control studies are costly and time-consuming. A case-case analyses using surveillance data addresses these limitations by using resources more efficiently. We conducted a case-case analyses using routine surveillance data reported by 16 U.S. states (2005-2015), wherein reported cases of salmonellosis were used as a comparison group to identify exposure associations with reported cases of cryptosporidiosis and giardiasis. Odds ratios adjusted for age and reporting state (aOR) and 95% confidence intervals (95% CI) were calculated. A total of 10 704 cryptosporidiosis cases, 17 544 giardiasis cases, and 106 351 salmonellosis cases were included in this analyses. When compared with cases of salmonellosis, exposure to treated recreational water (aOR 4.7, 95% CI 4.3-5.0) and livestock (aOR: 3.2; 95% CI: 2.9-3.5) were significantly associated with cryptosporidiosis and exposure to untreated drinking (aOR 4.1, 95% CI 3.6-4.7) and recreational water (aOR 4.1, 95% CI 3.7-4.5) were associated with giardiasis. Our analyses shows that routine surveillance data with standardised exposure information can be used to identify associations of interest for cryptosporidiosis and giardiasis.
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Affiliation(s)
- K M Benedict
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - S A Collier
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - E P Marder
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - M C Hlavsa
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - K E Fullerton
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - J S Yoder
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
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Benedict KM, Santibanez TA, Kahn KE, Pabst LJ, Bridges CB, Kennedy ED. Receipt and effectiveness of influenza vaccination reminders for adults, 2011-2012 season, United States. Influenza Other Respir Viruses 2018; 12:605-612. [PMID: 29681127 PMCID: PMC6086857 DOI: 10.1111/irv.12568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Reminders for influenza vaccination improve influenza vaccination coverage. The purpose of this study was to describe the receipt of reminders for influenza vaccination during the 2011-12 influenza season among US adults. METHODS We analyzed data from the March 2012 National Flu Survey (NFS), a random digit dial telephone survey of adults in the United States. Relative to July 1, 2011, respondents were asked whether they received a reminder for influenza vaccination and the source and type of reminder they received. The association between reminder receipt and demographic variables, and the association between influenza vaccination coverage and receipt of reminders were also examined. RESULTS Of adults interviewed, 17.2% reported receiving a reminder since July 1, 2011. More than half (65.2%) of the reminders were sent by doctor offices. Hispanics and non-Hispanic blacks were more likely than non-Hispanic whites to report receiving a reminder. Adults who reported having a usual healthcare provider, health insurance, or a high-risk condition were more likely to report receiving reminders than the respective reference group. Adults reporting receipt of reminders were 1.15 times more likely (adjusted prevalence ratio, 95% CI: 1.06-1.25) to report being vaccinated for influenza than adults reporting not receiving reminders. CONCLUSIONS Differences exist in receipt of influenza vaccination reminders among adults. Reminders are important tools to improve adult influenza vaccination coverage. Greater use of reminders may lead to higher rates of adult influenza vaccination coverage and reductions in influenza-related morbidity.
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Affiliation(s)
| | - Tammy A. Santibanez
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD)AtlantaGAUSA
| | | | - Laura J. Pabst
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD)AtlantaGAUSA
| | - Carolyn B. Bridges
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD)AtlantaGAUSA
| | - Erin D. Kennedy
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD)AtlantaGAUSA
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Benedict KM, Reses H, Vigar M, Roth DM, Roberts VA, Mattioli M, Cooley LA, Hilborn ED, Wade TJ, Fullerton KE, Yoder JS, Hill VR. Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water - United States, 2013-2014. MMWR Morb Mortal Wkly Rep 2017; 66:1216-1221. [PMID: 29121003 PMCID: PMC5679581 DOI: 10.15585/mmwr.mm6644a3] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Benedict KM, Santibanez TA, Black CL, Ding H, Graitcer SB, Bridges CB, Kennedy ED. Recommendations and offers for adult influenza vaccination, 2011-2012 season, United States. Vaccine 2017; 35:1353-1361. [PMID: 27137099 PMCID: PMC5689412 DOI: 10.1016/j.vaccine.2016.04.061] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Provider recommendations and offers for influenza vaccination improve adult influenza vaccination coverage. Analysis was performed to describe receipt of influenza vaccination recommendations and offers among adults who visited a healthcare provider (HCP) during the 2011-2012 influenza season and describe differences between those receiving and not receiving recommendations and offers for influenza vaccination. Associations between influenza vaccination and receipt of recommendations and offers were examined. METHODS Respondents to a random digit dial telephone survey who had visited a HCP since July 1, 2011 were asked if they had received a recommendation for influenza vaccination. Those receiving a recommendation were asked if they received an offer for vaccination. Participants were characterized by demographic and access to health care variables. Logistic regression was used to examine the relationships between participant characteristics and recommendation alone, between participant characteristics and recommendation and offer, and between influenza vaccination and recommendation and offer. RESULTS Of those who reported visiting a HCP, 43.8% reported receiving a recommendation for influenza vaccination. Of those who reported receiving a recommendation, 76.6% reported receiving an offer for influenza vaccination. Persons with high-risk conditions and persons over 65 years were more likely to receive recommendations for influenza vaccination when compared to those without high-risk conditions and 18-49 year olds, respectively. Those reporting receipt of a recommendation and offer for influenza vaccination were 1.76 times more likely and those reporting receipt of a recommendation but no offer were 1.72 times more likely to report being vaccinated for influenza controlling for all patient characteristics. CONCLUSIONS Less than half of respondents reported receipt of recommendations and offers of influenza vaccination during the 2011-2012 influenza season and disparities exist between groups. All healthcare providers seeing adults should recommend or offer influenza vaccination for all patients at every visit during the influenza season.
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Affiliation(s)
| | - Tammy A Santibanez
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), 1600 Clifton Road, NE, Mailstop A-19, Atlanta, GA, 30329-4027, USA.
| | - Carla L Black
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), 1600 Clifton Road, NE, Mailstop A-19, Atlanta, GA, 30329-4027, USA.
| | | | - Samuel B Graitcer
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), 1600 Clifton Road, NE, Mailstop A-19, Atlanta, GA, 30329-4027, USA.
| | - Carolyn B Bridges
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), 1600 Clifton Road, NE, Mailstop A-19, Atlanta, GA, 30329-4027, USA.
| | - Erin D Kennedy
- Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), 1600 Clifton Road, NE, Mailstop A-19, Atlanta, GA, 30329-4027, USA.
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Noyes NR, Benedict KM, Gow SP, Booker CW, Hannon SJ, McAllister TA, Morley PS. Mannheimia haemolytica in feedlot cattle: prevalence of recovery and associations with antimicrobial use, resistance, and health outcomes. J Vet Intern Med 2015; 29:705-13. [PMID: 25818224 PMCID: PMC4895489 DOI: 10.1111/jvim.12547] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/28/2014] [Accepted: 01/12/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Mannheimia haemolytica is an important etiological agent in bovine respiratory disease. OBJECTIVES Explore risk factors for recovery of susceptible and resistant M. haemolytica in feedlot cattle and explore associations with health outcomes. ANIMALS Cattle (n = 5,498) from 4 feedlots sampled at arrival and later in feeding period. METHODS Susceptibility of M. haemolytica isolates tested for 21 antimicrobials. Records of antimicrobial use and health events analyzed using multivariable regression. RESULTS M. haemolytica recovered from 29% of cattle (1,596/5,498), 13.1% at arrival (95% CI, 12.3-14.1%), and 19.8% at second sampling (95% CI, 18.7-20.9%). Nearly half of study cattle received antimicrobial drugs (AMDs) parenterally, mostly as metaphylactic treatment at arrival. Individual parenteral AMD exposures were associated with decreased recovery of M. haemolytica (OR, 0.2; 95% CI, 0.02-1.2), whereas exposure in penmates was associated with increased recovery (OR, 1.5; 95% CI, 1.05-2.2). Most isolates were pan-susceptible (87.8%; 95% CI, 87.0-89.4%). AMD exposures were not associated with resistance to any single drug. Multiply-resistant isolates were rare (5.9%; 95% CI, 5.1-6.9%), but AMD exposures in pen mates were associated with increased odds of recovering multiply-resistant M. haemolytica (OR, 23.9; 95% CI, 8.4-68.3). Cattle positive for M. haemolytica on arrival were more likely to become ill within 10 days (OR, 1.7; 95% CI, 1.1-2.4). CONCLUSIONS AND CLINICAL IMPORTANCE Resistance generally was rare in M. haemolytica. Antimicrobial drug exposures in penmates increased the risk of isolating susceptible and multiply-resistant M. haemolytica, a finding that could be explained by contagious spread.
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Affiliation(s)
- N R Noyes
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
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Benedict KM, Gow SP, McAllister TA, Booker CW, Hannon SJ, Checkley SL, Noyes NR, Morley PS. Antimicrobial Resistance in Escherichia coli Recovered from Feedlot Cattle and Associations with Antimicrobial Use. PLoS One 2015; 10:e0143995. [PMID: 26633649 PMCID: PMC4669080 DOI: 10.1371/journal.pone.0143995] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 11/12/2015] [Indexed: 11/18/2022] Open
Abstract
The objectives of this study were to estimate the prevalence of antimicrobial resistance (AMR) and to investigate the associations between exposures to antimicrobial drugs (AMDs) and AMR in fecal non-type specific Escherichia coli (NTSEC) recovered from a large population of feedlot cattle. Two-stage random sampling was used to select individually identified cattle for enrollment, which were sampled at arrival and then a second time later in the feeding period. Advanced regression techniques were used to estimate resistance prevalences, and to investigate associations between AMD exposures in enrolled cattle and penmates and AMR identified in NTSEC recovered from the second sample set. Resistance was most commonly detected to tetracycline, streptomycin, and sulfisoxazole, and was rarely identified for critically important AMDs. All cattle were exposed to AMDs in feed, and 45% were treated parenterally. While resistance prevalence generally increased during the feeding period, most AMD exposures were not significantly associated with AMR outcomes. Exposures of enrolled cattle to tetracycline were associated with increased resistance to tetracycline and trimethoprim sulfa, while beta-lactam exposures were associated with decreased likelihood of detecting streptomycin resistance. Pen-level AMD exposure measures were not associated with resistance outcomes. These findings suggest that tetracycline treatment of feedlot cattle can be associated with modest increases in risk for recovery of resistant NTSEC, but the numerous treatments with an advanced macrolide (tulathromycin) were not associated with detectable increases in resistance in NTSEC. All cattle were exposed to in-feed treatments of tetracycline and this could limit the ability to identify the full impact of these exposures, but these exposures varied for enrolled cattle varied, providing an opportunity to evaluate a dose response. While AMD exposures were not associated with detectably increased risks for resistance to critically important AMDs, rare resistance outcomes and infrequent exposure to other important AMDs (e.g., cephalosporins) limited our ability to rigorously investigate questions regarding factors that can influence resistance to these important AMDs.
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Affiliation(s)
- Katharine M. Benedict
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Sheryl P. Gow
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Tim A. McAllister
- Lethbridge Research Center, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Calvin W. Booker
- Feedlot Health Management Services, Ltd., Okotoks, Alberta, Canada
| | - Sherry J. Hannon
- Feedlot Health Management Services, Ltd., Okotoks, Alberta, Canada
| | - Sylvia L. Checkley
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Noelle R. Noyes
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Paul S. Morley
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
- * E-mail:
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Benedict KM, Gow SP, Checkley S, Booker CW, McAllister TA, Morley PS. Methodological comparisons for antimicrobial resistance surveillance in feedlot cattle. BMC Vet Res 2013; 9:216. [PMID: 24144185 PMCID: PMC3818683 DOI: 10.1186/1746-6148-9-216] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 10/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to objectively compare methodological approaches that might be utilized in designing an antimicrobial resistance (AMR) surveillance program in beef feedlot cattle. Specifically, four separate comparisons were made to investigate their potential impact on estimates for prevalence of AMR. These included investigating potential differences between 2 different susceptibility testing methods (broth microdilution and disc diffusion), between 2 different target bacteria (non-type-specific E. coli [NTSEC] and Mannheimia haemolytica), between 2 strategies for sampling feces (individual samples collected per rectum and pooled samples collected from the pen floor), and between 2 strategies for determining which cattle to sample (cattle that were culture-positive for Mannheimia haemolytica and those that were culture-negative). RESULTS Comparing two susceptibility testing methods demonstrated differences in the likelihood of detecting resistance between automated disk diffusion (BioMIC®) and broth microdilution (Sensititre®) for both E. coli and M. haemolytica. Differences were also detected when comparing resistance between two bacterial organisms within the same cattle; there was a higher likelihood of detecting resistance in E. coli than in M. haemolytica. Differences in resistance prevalence were not detected when using individual animal or composite pen sampling strategies. No differences in resistance prevalences were detected in E. coli recovered from cattle that were culture-positive for M. haemolytica compared to those that were culture-negative, suggesting that sampling strategies which targeted recovery of E. coli from M. haemolytica-positive cattle would not provide biased results. CONCLUSIONS We found that for general purposes, the susceptibility test selected for AMR surveillance must be carefully chosen considering the purpose of the surveillance since the ability to detect resistance appears to vary between these tests depending upon the population where they are applied. Continued surveillance of AMR in M. haemolytica recovered by nasopharyngeal swab is recommended if monitoring an animal health pathogen is an objective of the surveillance program as results of surveillance using fecal E. coli cannot be extrapolated to this important respiratory pathogen. If surveillance of E. coli was pursued in the same population, study populations could target animals that were culture-positive for M. haemolytica without biasing estimates for AMR in E. coli. Composite pen-floor sampling or sampling of individuals per-rectum could possibly be used interchangeably for monitoring resistance in E. coli.
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Affiliation(s)
| | | | | | | | | | - Paul S Morley
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523-1678, USA.
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Benedict KM, Gow SP, Reid-Smith RJ, Booker CW, Morley PS. Metrics for quantifying antimicrobial use in beef feedlots. Can Vet J 2012; 53:841-848. [PMID: 23372190 PMCID: PMC3398520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Accurate antimicrobial drug use data are needed to enlighten discussions regarding the impact of antimicrobial drug use in agriculture. The primary objective of this study was to investigate the perceived accuracy and clarity of different methods for reporting antimicrobial drug use information collected regarding beef feedlots. Producers, veterinarians, industry representatives, public health officials, and other knowledgeable beef industry leaders were invited to complete a web-based survey. A total of 156 participants in 33 US states, 4 Canadian provinces, and 8 other countries completed the survey. No single metric was considered universally optimal for all use circumstances or for all audiences. To effectively communicate antimicrobial drug use data, evaluation of the target audience is critical to presenting the information. Metrics that are most accurate need to be carefully and repeatedly explained to the audience.
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Costa MC, Reid-Smith R, Gow S, Hannon SJ, Booker C, Rousseau J, Benedict KM, Morley PS, Weese JS. Prevalence and molecular characterization of Clostridium difficile isolated from feedlot beef cattle upon arrival and mid-feeding period. BMC Vet Res 2012; 8:38. [PMID: 22455611 PMCID: PMC3353841 DOI: 10.1186/1746-6148-8-38] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 03/28/2012] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The presence of indistinguishable strains of Clostridium difficile in humans, food animals and food, as well as the apparent emergence of the food-animal-associated ribotype 078/toxinotype V as a cause of community-associated C. difficile infection have created concerns about the potential for foodborne infection. While studies have reported C. difficile in calves, studies of cattle closer to the age of harvest are required. Four commercial feedlots in Alberta (Canada) were enrolled for this study. Fecal samples were collected at the time of arrival and after acclimation (< 62, 62-71 or > 71 days on feed). Selective culture for Clostridium difficile was performed, and isolates were characterized by ribotyping and pulsed-field gel electrophoresis. A logistic regression model was built to investigate the effect of exposure to antimicrobial drugs on the presence of C. difficile. RESULTS Clostridium difficile was isolated from 18 of 539 animals at the time of feedlot arrival (CI = 2.3-6.1) and from 18 of 335 cattle at mid-feeding period (CI = 2.9-13.1). Overall, there was no significant difference in the prevalence of C. difficile shedding on arrival versus mid-feeding period (P = 0.47). No association between shedding of the bacterium and antimicrobial administration was found (P = 0.33). All the isolates recovered were ribotype 078, a toxinotype V strain with genes encoding toxins A, B and CDT. In addition, all strains were classified as NAP7 by pulsed field gel electrophoresis (PFGE) and had the characteristic 39 base pairs deletion and upstream truncating mutation on the tcdC gene. CONCLUSIONS It is apparent that C. difficile is carried in the intestinal tracts of a small percentage of feedlot cattle arriving and later in the feeding period and that ribotype 078/NAP7 is the dominant strain in these animals. Herd management practices associated with C. difficile shedding were not identified, however further studies of the potential role of antimicrobials on C. difficile acquisition and shedding are required.
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Affiliation(s)
- Marcio C Costa
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Canada
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Benedict KM, Morley PS, Van Metre DC. Characteristics of biosecurity and infection control programs at veterinary teaching hospitals. J Am Vet Med Assoc 2008; 233:767-73. [PMID: 18764716 DOI: 10.2460/javma.233.5.767] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize biosecurity and infection control practices at veterinary teaching hospitals located at institutions accredited by the AVMA. DESIGN Cross-sectional survey. POPULATION 50 biosecurity experts at 38 veterinary teaching hospitals. PROCEDURES Telephone interviews were conducted between July 2006 and July 2007, and questions were asked regarding policies for hygiene, surveillance, patient contact, education, and awareness. Respondents were also asked their opinion regarding the rigor of their programs. RESULTS 31 of 38 (82%) hospitals reported outbreaks of nosocomial infection during the 5 years prior to the interview, 17 (45%) reported > 1 outbreak, 22 (58%) had restricted patient admissions to aid mitigation, and 12 (32%) had completely closed sections of the facility to control disease spread. Nineteen (50%) hospitals reported that zoonotic infections had occurred during the 2 years prior to the interview. Only 16 (42%) hospitals required personnel to complete a biosecurity training program, but 20 of the 50 (40%) respondents indicated that they believed their hospitals ranked among the top 10% in regard to rigor of infection control efforts. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that differences existed among infection control programs at these institutions. Perceptions of experts regarding program rigor appeared to be skewed, possibly because of a lack of published data characterizing programs at other institutions. Results may provide a stimulus for hospital administrators to better optimize biosecurity and infection control programs at their hospitals and thereby optimize patient care.
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Affiliation(s)
- Katharine M Benedict
- Animal Population Health Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523-678, USA
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Morley PS, Traub-Dargatz JL, Benedict KM, Saville WJA, Voelker LD, Wagner BA. Risk factors for owner-reported occurrence of equine protozoal myeloencephalitis in the US equine population. J Vet Intern Med 2008; 22:616-29. [PMID: 18466255 DOI: 10.1111/j.1939-1676.2008.0082.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Equine protozoal myeloencephalitis (EPM) is a serious and often fatal neurologic disease of horses, but few studies have investigated risk factors. OBJECTIVES To evaluate operation- and individual-level factors associated with likelihood of the occurrence of EPM. ANIMALS Data were collected as part of a study of the US equine industry from 1,178 operations representing 83.9% of horses and 51.6% of operations with > or =3 horses in 28 states. METHODS Probability-based sampling was used to enroll representative operations in a cross-sectional study. Interviews were conducted to collect information regarding health and management of horses. A nested case-control study was used to investigate risk factors among individual horses. Interview data were combined with climate data, human population density, and opossum regional ecology categories. Data were analyzed using logistic regression to identify risk factors for the occurrence of EPM. RESULTS Owners reported that 95% of EPM cases included in this study were diagnosed by veterinarians. Variables associated with EPM occurrence on premises included opossum regional ecology, reported exposure to small wildlife, climate, terrain, housing, choice of bedding material, method of storing feeds, equine stocking density, and primary use of horses. Among individual horses, age was most strongly associated with disease risk. Associations also were identified with sex, breed, primary use, and participation in competitions. CONCLUSIONS AND CLINICAL IMPORTANCE Because the risk of EPM occurrence on operations is closely tied to factors that impact exposure to opossums, their feces, and their environment, controlling these exposures may be important in preventing the occurrence of EPM.
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Affiliation(s)
- P S Morley
- Animal Population Health Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
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