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Grossmann NV, Milne C, Martinez MR, Relucio K, Sadeghi B, Wiley EN, Holland SN, Rutschmann S, Vugia DJ, Kimura A, Crain C, Akter F, Mukhopadhyay R, Crandall J, Shorrock M, Smith JC, Prasad N, Kahn R, Barskey AE, Lee S, Willby MJ, Kozak-Muiznieks NA, Lucas CE, Henderson KC, Hamlin JAP, Yang E, Clemmons NS, Ritter T, Henn J. Large Community Outbreak of Legionnaires Disease Potentially Associated with a Cooling Tower - Napa County, California, 2022. MMWR Morb Mortal Wkly Rep 2023; 72:1315-1320. [PMID: 38060434 PMCID: PMC10715825 DOI: 10.15585/mmwr.mm7249a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Legionnaires disease is a serious infection acquired by inhalation of water droplets from human-made building water systems that contain Legionella bacteria. On July 11 and 12, 2022, Napa County Public Health (NCPH) in California received reports of three positive urinary antigen tests for Legionella pneumophila serogroup 1 in the town of Napa. By July 21, six Legionnaires disease cases had been confirmed among Napa County residents, compared with a baseline of one or two cases per year. NCPH requested assistance from the California Department of Public Health (CDPH) and CDC to aid in the investigations. Close temporal and geospatial clustering permitted a focused environmental sampling strategy of high-risk facilities which, coupled with whole genome sequencing results from samples and investigation of water system maintenance, facilitated potential linking of the outbreak with an environmental source. NCPH, with technical support from CDC and CDPH, instructed and monitored remediation practices for all environmental locations that tested positive for Legionella. The investigation response to this community outbreak illustrates the importance of interdisciplinary collaboration by public health agencies, laboratory support, timely communication with the public, and cooperation of managers of potentially implicated water systems. Timely identification of possible sources, sampling, and remediation of any facility testing positive for Legionella is crucial to interrupting further transmission.
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Valencia D, Yu AT, Wheeler A, Hopkins L, Pray I, Horter L, Vugia DJ, Matzinger S, Stadler L, Kloczko N, Welton M, Bertsch-Merbach S, Domakonda K, Antkiewicz D, Turner H, Crain C, Mulenga A, Shafer M, Owiti J, Schneider R, Janssen KH, Wolfe MK, McClellan SL, Boehm AB, Roguet A, White B, Schussman MK, Rane MS, Hemming J, Collins C, Abram A, Burnor E, Westergaard R, Ricaldi JN, Person J, Fehrenbach N. Notes from the Field: The National Wastewater Surveillance System's Centers of Excellence Contributions to Public Health Action During the Respiratory Virus Season - Four U.S. Jurisdictions, 2022-23. MMWR Morb Mortal Wkly Rep 2023; 72:1309-1312. [PMID: 38032883 DOI: 10.15585/mmwr.mm7248a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
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3
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Boehm AB, Wadford DA, Hughes B, Duong D, Chen A, Padilla T, Wright C, Moua L, Bullick T, Salas M, Morales C, White BJ, Glaser CA, Vugia DJ, Yu AT, Wolfe MK. Trends of Enterovirus D68 Concentrations in Wastewater, California, USA, February 2021-April 2023. Emerg Infect Dis 2023; 29:2362-2365. [PMID: 37877593 PMCID: PMC10617337 DOI: 10.3201/eid2911.231080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
In this retrospective study, we measured enterovirus D68 (EV-D68) genomic RNA in wastewater solids longitudinally at 2 California, USA, wastewater treatment plants twice per week for 26 months. EV-D68 RNA was undetectable except when concentrations increased from mid-July to mid-December 2022, which coincided with a peak in confirmed EV-D68 cases.
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Affiliation(s)
| | | | - Bridgette Hughes
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Dorothea Duong
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Alice Chen
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Tasha Padilla
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Chelsea Wright
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Lisa Moua
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Teal Bullick
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Maria Salas
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Christina Morales
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Bradley J. White
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Carol A. Glaser
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Duc J. Vugia
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Alexander T. Yu
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
| | - Marlene K. Wolfe
- Stanford University, Stanford, California, USA (A.B. Boehm)
- California Department of Public Health, Richmond, California, USA (D.A. Wadford, A. Chen, T. Padilla, C. Wright, L. Moua, T. Bullick, M. Salas, C. Morales, C.A. Glaser, D.J. Vugia, A.T. Yu)
- Verily Life Sciences, South San Francisco, California, USA (B. Hughes, D. Duong, B.J. White)
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA (M.K. Wolfe)
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Rabe A, Ravuri S, Burnor E, Steele JA, Kantor RS, Choi S, Forman S, Batjiaka R, Jain S, León TM, Vugia DJ, Yu AT. Correlation between wastewater and COVID-19 case incidence rates in major California sewersheds across three variant periods. J Water Health 2023; 21:1303-1317. [PMID: 37756197 PMCID: wh_2023_173 DOI: 10.2166/wh.2023.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Monitoring for COVID-19 through wastewater has been used for adjunctive public health surveillance, with SARS-CoV-2 viral concentrations in wastewater correlating with incident cases in the same sewershed. However, the generalizability of these findings across sewersheds, laboratory methods, and time periods with changing variants and underlying population immunity has not been well described. The California Department of Public Health partnered with six wastewater treatment plants starting in January 2021 to monitor wastewater for SARS-CoV-2, with analyses performed at four laboratories. Using reported PCR-confirmed COVID-19 cases within each sewershed, the relationship between case incidence rates and wastewater concentrations collected over 14 months was evaluated using Spearman's correlation and linear regression. Strong correlations were observed when wastewater concentrations and incidence rates were averaged (10- and 7-day moving window for wastewater and cases, respectively, ρ = 0.73-0.98 for N1 gene target). Correlations remained strong across three time periods with distinct circulating variants and vaccination rates (winter 2020-2021/Alpha, summer 2021/Delta, and winter 2021-2022/Omicron). Linear regression revealed that slopes of associations varied by the dominant variant of concern, sewershed, and laboratory (β = 0.45-1.94). These findings support wastewater surveillance as an adjunctive public health tool to monitor SARS-CoV-2 community trends.
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Affiliation(s)
- Angela Rabe
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA; These first authors contributed equally to this manuscript. E-mail:
| | - Sindhu Ravuri
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA; These first authors contributed equally to this manuscript
| | - Elisabeth Burnor
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
| | - Joshua A Steele
- Southern California Coastal Water Research Project (SCCWRP), Department of Microbiology, Costa Mesa, CA, USA
| | - Rose S Kantor
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - Samuel Choi
- Orange County Sanitation District, Fountain Valley, CA, USA
| | - Stanislav Forman
- Zymo Research Corp. Department of Sample Collection and Nucleic Acid Purification, Zymo Research Corp., Irvine, CA, USA
| | - Ryan Batjiaka
- San Francisco Public Utilities Commission, San Francisco, CA, USA
| | - Seema Jain
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
| | - Tomás M León
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
| | - Duc J Vugia
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
| | - Alexander T Yu
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
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5
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Ford L, Healy JM, Cui Z, Ahart L, Medalla F, Ray LC, Reynolds J, Laughlin ME, Vugia DJ, Hanna S, Bennett C, Chen J, Rose EB, Bruce BB, Payne DC, Francois Watkins LK. Epidemiology and Antimicrobial Resistance of Campylobacter Infections in the United States, 2005-2018. Open Forum Infect Dis 2023; 10:ofad378. [PMID: 37559755 PMCID: PMC10407460 DOI: 10.1093/ofid/ofad378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/13/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Campylobacter is the most common cause of bacterial diarrhea in the United States; resistance to macrolides and fluoroquinolones limits treatment options. We examined the epidemiology of US Campylobacter infections and changes in resistance over time. METHODS The Foodborne Diseases Active Surveillance Network receives information on laboratory-confirmed Campylobacter cases from 10 US sites, and the National Antimicrobial Resistance Monitoring System receives a subset of isolates from these cases for antimicrobial susceptibility testing. We estimated trends in incidence of Campylobacter infection, adjusting for sex, age, and surveillance changes attributable to culture-independent diagnostic tests. We compared percentages of isolates resistant to erythromycin or ciprofloxacin during 2005-2016 with 2017-2018 and used multivariable logistic regression to examine the association of international travel with resistance. RESULTS Adjusted Campylobacter incidence remained stable or decreased for all groups analyzed since 2012. Among 2449 linked records in 2017-2018, the median patient age was 40.2 years (interquartile range, 21.6-57.8 years), 54.8% of patients were male, 17.2% were hospitalized, and 0.2% died. The percentage of resistant infections increased from 24.5% in 2005-2016 to 29.7% in 2017-2018 for ciprofloxacin (P < .001) and from 2.6% to 3.3% for erythromycin (P = .04). Persons with recent international travel had higher odds than nontravelers of having isolates resistant to ciprofloxacin (adjusted odds ratio [aOR] varied from 1.7 to 10.6 by race/ethnicity) and erythromycin (aOR = 1.7; 95% confidence interval, 1.3-2.1). CONCLUSIONS Campylobacter incidence has remained stable or decreased, whereas resistance to antimicrobials recommended for treatment has increased. Recent international travel increased the risk of resistance.
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Affiliation(s)
- Laura Ford
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessica M Healy
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Zhaohui Cui
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lauren Ahart
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Felicita Medalla
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Logan C Ray
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jared Reynolds
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mark E Laughlin
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Duc J Vugia
- California Department of Public Health, Richmond, California, USA
| | - Samir Hanna
- Tennessee Department of Health, Nashville, Tennessee, USA
| | - Christy Bennett
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessica Chen
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Erica Billig Rose
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Beau B Bruce
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Daniel C Payne
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Louise K Francois Watkins
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Marder EP, Cui Z, Bruce BB, Richardson LC, Boyle MM, Cieslak PR, Comstock N, Lathrop S, Garman K, McGuire S, Olson D, Vugia DJ, Wilson S, Griffin PM, Medus C. Risk Factors for Non-O157 Shiga Toxin-Producing Escherichia coli Infections, United States. Emerg Infect Dis 2023; 29:1183-1190. [PMID: 37209671 DOI: 10.3201/eid2906.221521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
Shiga toxin-producing Escherichia coli (STEC) causes acute diarrheal illness. To determine risk factors for non-O157 STEC infection, we enrolled 939 patients and 2,464 healthy controls in a case-control study conducted in 10 US sites. The highest population-attributable fractions for domestically acquired infections were for eating lettuce (39%), tomatoes (21%), or at a fast-food restaurant (23%). Exposures with 10%-19% population attributable fractions included eating at a table service restaurant, eating watermelon, eating chicken, pork, beef, or iceberg lettuce prepared in a restaurant, eating exotic fruit, taking acid-reducing medication, and living or working on or visiting a farm. Significant exposures with high individual-level risk (odds ratio >10) among those >1 year of age who did not travel internationally were all from farm animal environments. To markedly decrease the number of STEC-related illnesses, prevention measures should focus on decreasing contamination of produce and improving the safety of foods prepared in restaurants.
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Wolfe MK, Yu AT, Duong D, Rane MS, Hughes B, Chan-Herur V, Donnelly M, Chai S, White BJ, Vugia DJ, Boehm AB. Use of Wastewater for Mpox Outbreak Surveillance in California. N Engl J Med 2023; 388:570-572. [PMID: 36652340 DOI: 10.1056/nejmc2213882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | | | | | | | | | | | | | - Shua Chai
- Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Duc J Vugia
- California Department of Public Health, Richmond, CA
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Collins JP, Shah HJ, Weller DL, Ray LC, Smith K, McGuire S, Trevejo RT, Jervis RH, Vugia DJ, Rissman T, Garman KN, Lathrop S, LaClair B, Boyle MM, Harris S, Kufel JZ, Tauxe RV, Bruce BB, Rose EB, Griffin PM, Payne DC. Preliminary Incidence and Trends of Infections Caused by Pathogens Transmitted Commonly Through Food - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2016-2021. MMWR Morb Mortal Wkly Rep 2022; 71:1260-1264. [PMID: 36201372 PMCID: PMC9541031 DOI: 10.15585/mmwr.mm7140a2] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Head JR, Sondermeyer-Cooksey G, Heaney AK, Yu AT, Jones I, Bhattachan A, Campo SK, Wagner R, Mgbara W, Phillips S, Keeney N, Taylor J, Eisen E, Lettenmaier DP, Hubbard A, Okin GS, Vugia DJ, Jain S, Remais JV. Effects of precipitation, heat, and drought on incidence and expansion of coccidioidomycosis in western USA: a longitudinal surveillance study. Lancet Planet Health 2022; 6:e793-e803. [PMID: 36208642 PMCID: PMC10189771 DOI: 10.1016/s2542-5196(22)00202-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/24/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 05/20/2023]
Abstract
BACKGROUND Drought is an understudied driver of infectious disease dynamics. Amidst the ongoing southwestern North American megadrought, California (USA) is having the driest multi-decadal period since 800 CE, exacerbated by anthropogenic warming. In this study, we aimed to examine the influence of drought on coccidioidomycosis, an emerging infectious disease in southwestern USA. METHODS We analysed California census tract-level surveillance data from 2000 to 2020 using generalised additive models and distributed monthly lags on precipitation and temperature. We then developed an ensemble prediction algorithm of incident cases of coccidioidomycosis per census tract to estimate the counterfactual incidence that would have occurred in the absence of drought. FINDINGS Between April 1, 2000, and March 31, 2020, there were 81 448 reported cases of coccidioidomycosis throughout California. An estimated 1467 excess cases of coccidioidomycosis were observed in California in the 2 years following the drought that occurred between 2007 and 2009, and an excess 2649 drought-attributable cases of coccidioidomycosis were observed in the 2 years following the drought that occurred between 2012 and 2015. These increased numbers of cases more than offset the declines in cases that occurred during drought. An IQR increase in summer temperatures was associated with 2·02 (95% CI 1·84-2·22) times higher incidence in the following autumn (September to November), and an IQR increase in precipitation in the winter was associated with 1·45 (1·36-1·55) times higher incidence in the autumn. The effect of winter precipitation was 36% (25-48) stronger when preceded by two dry, rather than average, winters. Incidence in arid counties was most sensitive to precipitation fluctuations, while incidence in wetter counties was most sensitive to temperature. INTERPRETATION In California, multi-year cycles of dry conditions followed by a wet winter increases transmission of coccidioidomycosis, especially in historically wetter areas. With anticipated increasing frequency of drought in southwestern USA, continued expansion of coccidioidomycosis, along with more intense seasons, is expected. Our results motivate the need for heightened precautions against coccidioidomycosis in seasons that follow major droughts. FUNDING National Institutes of Health.
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Affiliation(s)
- Jennifer R Head
- Division of Epidemiology, University of California, Berkeley, Berkeley, CA, USA; Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | | | - Alexandra K Heaney
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - Alexander T Yu
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | - Isabel Jones
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | | | - Simon K Campo
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - Robert Wagner
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Whitney Mgbara
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Sophie Phillips
- College of Letters and Science, University of California, Berkeley, Berkeley, CA, USA
| | - Nicole Keeney
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - John Taylor
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Ellen Eisen
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | | | - Alan Hubbard
- Division of Biostatistics, University of California, Berkeley, Berkeley, CA, USA
| | - Gregory S Okin
- Department of Geography, University of California, Berkeley, Berkeley, CA, USA
| | - Duc J Vugia
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | - Seema Jain
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | - Justin V Remais
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA.
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10
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Edmunds S, Vugia DJ, Rosen HE, Wong KK, Dykes JK, Griffin PM, Chatham-Stephens K. Inadequate Refrigeration of Some Commercial Foods Is a Continued Cause of Foodborne Botulism in the United States, 1994-2021. Foodborne Pathog Dis 2022; 19:417-422. [PMID: 35713923 PMCID: PMC11057212 DOI: 10.1089/fpd.2021.0023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 11/12/2022] Open
Abstract
Foodborne botulism is a rapidly progressive potentially fatal paralyzing illness caused by the consumption of botulinum neurotoxin, which is most commonly produced by Clostridium botulinum. Refrigeration is the primary barrier to botulinum neurotoxin production in many processed foods. C. botulinum toxin production has occurred and caused botulism in the United States when foods that were not processed to destroy spores of C. botulinum were stored in an anaerobic environment and not properly refrigerated. We identified 37 cases, including 4 deaths, that occurred during 1994-2021 in the United States from 13 events associated with inadequate refrigeration of commercially produced products. In 11 events, the patient stored the product unrefrigerated at home; in 2 events, a product was kept unrefrigerated at the store before the consumer purchased it. In three events, refrigeration instructions were inadequate or not easily accessible (one label printed on outer but not inner packaging, one label not clearly visible, and one label was not in English). The number of people affected per event ranged from 1 to 16. Using enhanced cost estimates for foodborne botulism cases from a published economic model, these events were estimated to cost >$79M. Potential solutions to this recurring problem include the addition of a secondary barrier, such as an acidifier, to prevent botulinum toxin production, and better labeling to convey risks of refrigerated foods that have not been processed to destroy spores of C. botulinum and to decrease the occurrence of improper storage and handling.
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Affiliation(s)
- Seth Edmunds
- Centers for Disease Control and Prevention, Enteric Diseases Epidemiology Branch, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Duc J. Vugia
- California Department of Public Health, Richmond and Los Angeles, California, USA
| | - Hilary E. Rosen
- California Department of Public Health, Richmond and Los Angeles, California, USA
| | - Karen K. Wong
- Centers for Disease Control and Prevention, Enteric Diseases Epidemiology Branch, Atlanta, Georgia, USA
| | - Janet K. Dykes
- Centers for Disease Control and Prevention, Enteric Diseases Laboratory Branch, Atlanta, Georgia, USA
| | - Patricia M. Griffin
- Centers for Disease Control and Prevention, Enteric Diseases Epidemiology Branch, Atlanta, Georgia, USA
| | - Kevin Chatham-Stephens
- Centers for Disease Control and Prevention, Enteric Diseases Epidemiology Branch, Atlanta, Georgia, USA
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11
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Yu AT, Hughes B, Wolfe MK, Leon T, Duong D, Rabe A, Kennedy LC, Ravuri S, White BJ, Wigginton KR, Boehm AB, Vugia DJ. Estimating Relative Abundance of 2 SARS-CoV-2 Variants through Wastewater Surveillance at 2 Large Metropolitan Sites, United States. Emerg Infect Dis 2022; 28:940-947. [PMID: 35349402 DOI: 10.21203/rs.3.rs-1083575/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) is critical for public health management of coronavirus disease. Sequencing is resource-intensive and incompletely representative, and not all isolates can be sequenced. Because wastewater SARS-CoV-2 RNA concentrations correlate with coronavirus disease incidence in sewersheds, tracking VOCs through wastewater is appealing. We developed digital reverse transcription PCRs to monitor abundance of select mutations in Alpha and Delta VOCs in wastewater settled solids, applied these to July 2020-August 2021 samples from 2 large US metropolitan sewersheds, and compared results to estimates of VOC abundance from case isolate sequencing. Wastewater measurements tracked closely with case isolate estimates (Alpha, rp 0.82-0.88; Delta, rp 0.97). Mutations were detected in wastewater even at levels <5% of total SARS-CoV-2 RNA and in samples available 1-3 weeks before case isolate results. Wastewater variant monitoring should be strategically deployed to complement case isolate sequencing.
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12
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Yu AT, Hughes B, Wolfe MK, Leon T, Duong D, Rabe A, Kennedy LC, Ravuri S, White BJ, Wigginton KR, Boehm AB, Vugia DJ. Estimating Relative Abundance of 2 SARS-CoV-2 Variants through Wastewater Surveillance at 2 Large Metropolitan Sites, United States. Emerg Infect Dis 2022; 28:940-947. [PMID: 35349402 PMCID: PMC9045426 DOI: 10.3201/eid2805.212488] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) is critical for public health management of coronavirus disease. Sequencing is resource-intensive and incompletely representative, and not all isolates can be sequenced. Because wastewater SARS-CoV-2 RNA concentrations correlate with coronavirus disease incidence in sewersheds, tracking VOCs through wastewater is appealing. We developed digital reverse transcription PCRs to monitor abundance of select mutations in Alpha and Delta VOCs in wastewater settled solids, applied these to July 2020–August 2021 samples from 2 large US metropolitan sewersheds, and compared results to estimates of VOC abundance from case isolate sequencing. Wastewater measurements tracked closely with case isolate estimates (Alpha, rp 0.82–0.88; Delta, rp 0.97). Mutations were detected in wastewater even at levels <5% of total SARS-CoV-2 RNA and in samples available 1–3 weeks before case isolate results. Wastewater variant monitoring should be strategically deployed to complement case isolate sequencing.
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13
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Kirby AE, Welsh RM, Marsh ZA, Yu AT, Vugia DJ, Boehm AB, Wolfe MK, White BJ, Matzinger SR, Wheeler A, Bankers L, Andresen K, Salatas C, Gregory DA, Johnson MC, Trujillo M, Kannoly S, Smyth DS, Dennehy JJ, Sapoval N, Ensor K, Treangen T, Stadler LB, Hopkins L. Notes from the Field: Early Evidence of the SARS-CoV-2 B.1.1.529 (Omicron) Variant in Community Wastewater - United States, November-December 2021. MMWR Morb Mortal Wkly Rep 2022; 71:103-105. [PMID: 35051130 PMCID: PMC8774157 DOI: 10.15585/mmwr.mm7103a5] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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14
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Wolfe MK, Topol A, Knudson A, Simpson A, White B, Vugia DJ, Yu AT, Li L, Balliet M, Stoddard P, Han GS, Wigginton KR, Boehm AB. High-Frequency, High-Throughput Quantification of SARS-CoV-2 RNA in Wastewater Settled Solids at Eight Publicly Owned Treatment Works in Northern California Shows Strong Association with COVID-19 Incidence. mSystems 2021; 6:e0082921. [PMID: 34519528 PMCID: PMC8547422 DOI: 10.1128/msystems.00829-21] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/30/2021] [Indexed: 01/19/2023] Open
Abstract
A number of recent retrospective studies have demonstrated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentrations in wastewater are associated with coronavirus disease 2019 (COVID-19) cases in the corresponding sewersheds. Implementing high-resolution, prospective efforts across multiple plants depends on sensitive measurements that are representative of COVID-19 cases, scalable for high-throughput analysis, and comparable across laboratories. We conducted a prospective study across eight publicly owned treatment works (POTWs). A focus on SARS-CoV-2 RNA in solids enabled us to scale up our measurements with a commercial lab partner. Samples were collected daily, and results were posted to a website within 24 h. SARS-CoV-2 RNA in daily samples correlated with the incidence of COVID-19 cases in the sewersheds; a 1 log10 increase in SARS-CoV-2 RNA in settled solids corresponds to a 0.58 log10 (4×) increase in sewershed incidence rate. SARS-CoV-2 RNA signals measured with the commercial laboratory partner were comparable across plants and comparable to measurements conducted in a university laboratory when normalized by pepper mild mottle virus (PMMoV) RNA. Results suggest that SARS-CoV-2 RNA should be detectable in settled solids for COVID-19 incidence rates of >1/100,000 (range, 0.8 to 2.3 cases per 100,000). These sensitive, representative, scalable, and comparable methods will be valuable for future efforts to scale up wastewater-based epidemiology. IMPORTANCE Access to reliable, rapid monitoring data is critical to guide response to an infectious disease outbreak. For pathogens that are shed in feces or urine, monitoring wastewater can provide a cost-effective snapshot of transmission in an entire community via a single sample. In order for a method to be useful for ongoing COVID-19 monitoring, it should be sensitive for detection of low concentrations of SARS-CoV-2, representative of incidence rates in the community, scalable to generate data quickly, and comparable across laboratories. This paper presents a method utilizing wastewater solids to meet these goals, producing measurements of SARS-CoV-2 RNA strongly associated with COVID-19 cases in the sewershed of a publicly owned treatment work. Results, provided within 24 h, can be used to detect incidence rates as low as approximately 1/100,000 cases and can be normalized for comparison across locations generating data using different methods.
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Affiliation(s)
- Marlene K. Wolfe
- Department of Civil & Environmental Engineering, Stanford University, Stanford, California, USA
| | - Aaron Topol
- Verily Life Sciences, South San Francisco, California, USA
| | - Alisha Knudson
- Verily Life Sciences, South San Francisco, California, USA
| | - Adrian Simpson
- Verily Life Sciences, South San Francisco, California, USA
| | - Bradley White
- Verily Life Sciences, South San Francisco, California, USA
| | - Duc J. Vugia
- California Department of Public Health, Infectious Diseases Branch, Richmond, California, USA
| | - Alexander T. Yu
- California Department of Public Health, Infectious Diseases Branch, Richmond, California, USA
| | - Linlin Li
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Michael Balliet
- County of Santa Clara Department of Environmental Health, San Jose, California, USA
| | - Pamela Stoddard
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - George S. Han
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Krista R. Wigginton
- Department of Civil & Environmental Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Alexandria B. Boehm
- Department of Civil & Environmental Engineering, Stanford University, Stanford, California, USA
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15
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Wolfe MK, Topol A, Knudson A, Simpson A, White B, Vugia DJ, Yu AT, Li L, Balliet M, Stoddard P, Han GS, Wigginton KR, Boehm AB. High-Frequency, High-Throughput Quantification of SARS-CoV-2 RNA in Wastewater Settled Solids at Eight Publicly Owned Treatment Works in Northern California Shows Strong Association with COVID-19 Incidence. mSystems 2021; 6:e0082921. [PMID: 34519528 DOI: 10.1101/2021.07.16.21260627] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
A number of recent retrospective studies have demonstrated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentrations in wastewater are associated with coronavirus disease 2019 (COVID-19) cases in the corresponding sewersheds. Implementing high-resolution, prospective efforts across multiple plants depends on sensitive measurements that are representative of COVID-19 cases, scalable for high-throughput analysis, and comparable across laboratories. We conducted a prospective study across eight publicly owned treatment works (POTWs). A focus on SARS-CoV-2 RNA in solids enabled us to scale up our measurements with a commercial lab partner. Samples were collected daily, and results were posted to a website within 24 h. SARS-CoV-2 RNA in daily samples correlated with the incidence of COVID-19 cases in the sewersheds; a 1 log10 increase in SARS-CoV-2 RNA in settled solids corresponds to a 0.58 log10 (4×) increase in sewershed incidence rate. SARS-CoV-2 RNA signals measured with the commercial laboratory partner were comparable across plants and comparable to measurements conducted in a university laboratory when normalized by pepper mild mottle virus (PMMoV) RNA. Results suggest that SARS-CoV-2 RNA should be detectable in settled solids for COVID-19 incidence rates of >1/100,000 (range, 0.8 to 2.3 cases per 100,000). These sensitive, representative, scalable, and comparable methods will be valuable for future efforts to scale up wastewater-based epidemiology. IMPORTANCE Access to reliable, rapid monitoring data is critical to guide response to an infectious disease outbreak. For pathogens that are shed in feces or urine, monitoring wastewater can provide a cost-effective snapshot of transmission in an entire community via a single sample. In order for a method to be useful for ongoing COVID-19 monitoring, it should be sensitive for detection of low concentrations of SARS-CoV-2, representative of incidence rates in the community, scalable to generate data quickly, and comparable across laboratories. This paper presents a method utilizing wastewater solids to meet these goals, producing measurements of SARS-CoV-2 RNA strongly associated with COVID-19 cases in the sewershed of a publicly owned treatment work. Results, provided within 24 h, can be used to detect incidence rates as low as approximately 1/100,000 cases and can be normalized for comparison across locations generating data using different methods.
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Affiliation(s)
- Marlene K Wolfe
- Department of Civil & Environmental Engineering, Stanford Universitygrid.168010.e, Stanford, California, USA
| | - Aaron Topol
- Verily Life Sciences, South San Francisco, California, USA
| | - Alisha Knudson
- Verily Life Sciences, South San Francisco, California, USA
| | - Adrian Simpson
- Verily Life Sciences, South San Francisco, California, USA
| | - Bradley White
- Verily Life Sciences, South San Francisco, California, USA
| | - Duc J Vugia
- California Department of Public Health, Infectious Diseases Branch, Richmond, California, USA
| | - Alexander T Yu
- California Department of Public Health, Infectious Diseases Branch, Richmond, California, USA
| | - Linlin Li
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Michael Balliet
- County of Santa Clara Department of Environmental Health, San Jose, California, USA
| | - Pamela Stoddard
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - George S Han
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Krista R Wigginton
- Department of Civil & Environmental Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Alexandria B Boehm
- Department of Civil & Environmental Engineering, Stanford Universitygrid.168010.e, Stanford, California, USA
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16
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Snyder RE, Cooksey GS, Kramer V, Jain S, Vugia DJ. West Nile Virus-Associated Hospitalizations, California, 2004-2017. Clin Infect Dis 2021; 73:441-447. [PMID: 32525967 DOI: 10.1093/cid/ciaa749] [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: 12/03/2019] [Accepted: 06/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND West Nile virus (WNV) is the most commonly reported mosquito-borne disease in the USA. California reports more WNV disease than any other state. METHODS We identified WNV-associated hospitalizations from 2004 through 2017 in California and estimated hospitalization incidence using Patient Discharge Data. We described demographic, geographic, and clinical characteristics of WNV hospitalizations; identified risk factors for in-hospital death; and tabulated hospitalization charges. RESULTS From 2004 through 2017, 3109 Californians were hospitalized with WNV (median, 214 patients/year; range, 72-449). The majority were male (1983; 63.8%) and aged ≥60 years (1766; 56.8%). The highest median annual hospitalization rate (0.88 hospitalizations/100 000 persons) was in the Central Valley, followed by southern California (0.59 hospitalizations/100 000 persons). Most patients (2469; 79.4%) had ≥1 underlying condition, including hypertension, cardiovascular disease, diabetes, chronic kidney disease, or immunosuppression due to medications or disease. Median hospitalization length of stay was 12 days (interquartile range, 6-23 days). During hospitalization, 1317 (42%) patients had acute respiratory failure and/or sepsis/septic shock, 772 (24.8%) experienced acute kidney failure, and 470 (15.1%) had paralysis; 272 (8.8%) patients died. Nearly 47% (1444) of patients were discharged for additional care. During these 14 years, $838 680 664 (mean $59.9 million/year) was charged for WNV hospitalizations, 73.9% through government payers at a median charge of $142 321/patient. CONCLUSIONS WNV-associated hospitalizations were substantial and costly in California. Hospitalization incidence was higher in males, elderly persons, and patients with underlying conditions. WNV persists as a costly and severe public health threat in California.
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Affiliation(s)
- Robert E Snyder
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
| | - Gail Sondermeyer Cooksey
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
| | - Vicki Kramer
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
| | - Seema Jain
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
| | - Duc J Vugia
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
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17
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Fritz CL, Nguyen A, Vugia DJ. Epidemiology of Brucellosis in California, 1993 - 2017: A Continuing Foodborne Disease Risk for Older Latinos. Clin Infect Dis 2021; 73:2023-2030. [PMID: 34134141 DOI: 10.1093/cid/ciab551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Brucellosis is a severe, occupational or foodborne zoonosis throughout much of the world. Although eradicated from domestic cattle in the United States, brucellosis remains a disease risk to people through acquisition and consumption of animal products from endemic countries. METHODS Cases of human brucellosis reported through the California public health disease surveillance network were reviewed for 1993 to 2017. RESULTS From 1993 to 2017, 492 cases of brucellosis were reported in residents of California. Persons aged ≥65 years represented less than 20% of cases, but incidence in this age group (0.94 cases per 10 6 population per year) was more than twice the incidence in persons aged ≤19 years (0.44). Incidence was 10 to 20 times greater among Latinos compared to non-Latinos across all age groups and both sexes. Brucella melitensis was identified in 80% of patients for whom cultured Brucella were identified to species. Of 187 case-patients who reported consuming specifically unpasteurized dairy products, over 90% reported acquiring these products from outside the United States, most commonly from Mexico. In the latter half of the study period (2006-2017), 73% of Latino case-patients who reported consuming dairy products mentioned specifically consuming Mexican-style soft cheese ("queso fresco"). CONCLUSIONS This study underscores the continuing serious health threat of brucellosis for Latinos in California, particularly older men, and the need for targeted public health messaging on preventing the risk presented by importation and consumption of unpasteurized dairy products from outside the United States, principally Mexico.
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Affiliation(s)
- Curtis L Fritz
- Infectious Diseases Branch, Center for Infectious Diseases, California Department of Public Health, USA
| | - Alyssa Nguyen
- Infectious Diseases Branch, Center for Infectious Diseases, California Department of Public Health, USA
| | - Duc J Vugia
- Infectious Diseases Branch, Center for Infectious Diseases, California Department of Public Health, USA
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18
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Wolfe MK, Archana A, Catoe D, Coffman MM, Dorevich S, Graham KE, Kim S, Grijalva LM, Roldan-Hernandez L, Silverman AI, Sinnott-Armstrong N, Vugia DJ, Yu AT, Zambrana W, Wigginton KR, Boehm AB. Scaling of SARS-CoV-2 RNA in Settled Solids from Multiple Wastewater Treatment Plants to Compare Incidence Rates of Laboratory-Confirmed COVID-19 in Their Sewersheds. Environ Sci Technol Lett 2021; 8:398-404. [PMID: 37566351 PMCID: PMC8056949 DOI: 10.1021/acs.estlett.1c00184] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 05/19/2023]
Abstract
Published and unpublished reports show that SARS-CoV-2 RNA in publicly owned treatment work (POTW) wastewater influent and solids is associated with new COVID-19 cases or incidence in associated sewersheds, but methods for comparing data collected from diverse POTWs to infer information about the relative incidence of laboratory-confirmed COVID-19 cases, and scaling to allow such comparisons, have not been previously established. Here, we show that SARS-CoV-2 N1 and N2 concentrations in solids normalized by concentrations of PMMoV RNA in solids can be used to compare incidence of laboratory confirmed new COVID-19 cases across POTWs. Using data collected at seven POTWs along the United States West Coast, Midwest, and East Coast serving ∼3% of the U.S. population (9 million people), we show that a 1 log change in N gene/PMMoV is associated with a 0.24 (range 0.19 to 0.29) log10 change in incidence of laboratory confirmed COVID-19. Scaling of N1 and N2 by PMMoV is consistent, conceptually, with a mass balance model relating SARS-CoV-2 RNA to the number of infected individuals shedding virus in their stool. This information should support the application of wastewater-based epidemiology to inform the response to the COVID-19 pandemic and potentially future viral pandemics.
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Affiliation(s)
- Marlene K. Wolfe
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Anand Archana
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - David Catoe
- Joint Initiative for Metrology in Biology,
SLAC National Accelerator Laboratory, Stanford, California
94305, United States
| | - Mhara M. Coffman
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Samuel Dorevich
- Division of Environmental and Occupational Health
Sciences, School of Public Health, University of Illinois,
Chicago, Illinois 60612, United States
| | - Katherine E. Graham
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Sooyeol Kim
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Lorelay Mendoza Grijalva
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Laura Roldan-Hernandez
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Andrea I. Silverman
- Department of Civil and Urban Engineering, Tandon
School of Engineering, New York University, Brooklyn, New York
11201, United States
- School of Global Public Health, New York
University, New York, New York 10003, United
States
| | - Nasa Sinnott-Armstrong
- Department of Genetics, Stanford University
School of Medicine, Stanford, California 94305, United
States
| | - Duc J. Vugia
- Infectious Diseases Branch, California
Department of Public Health, Richmond, California 94804, United
States
| | - Alexander T. Yu
- Infectious Diseases Branch, California
Department of Public Health, Richmond, California 94804, United
States
| | - Winnie Zambrana
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Krista R. Wigginton
- Department of Civil and Environmental Engineering,
University of Michigan,Ann Arbor, Michigan 48109,
United States
| | - Alexandria B. Boehm
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
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19
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Laws RL, Jain S, Cooksey GS, Mohle-Boetani J, McNary J, Wilken J, Harrison R, Leistikow B, Vugia DJ, Windham GC, Materna BL. Coccidioidomycosis outbreak among inmate wildland firefighters: California, 2017. Am J Ind Med 2021; 64:266-273. [PMID: 33484179 PMCID: PMC8935635 DOI: 10.1002/ajim.23218] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 06/15/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND In California, state prison inmates are employed to fight wildfires, which involves performing soil-disrupting work. Wildfires have become more common, including areas where Coccidioides, the soil-dwelling fungus that causes coccidioidomycosis, proliferates. However, work practices that place wildland firefighters at risk for coccidioidomycosis have not been investigated. METHODS On August 17, 2017, the California Department of Public Health was notified of a cluster of coccidioidomycosis cases among Wildfire A inmate wildland firefighters. We collected data through medical record abstraction from suspected case-patients and mailed a survey assessing potential job task risk factors to Wildfire A inmate firefighters. We described respondent characteristics and conducted a retrospective case-control investigation to assess coccidioidomycosis risk factors. RESULTS Among 198 inmate firefighters who worked on Wildfire A, 112 (57%) completed the survey. Of 10 case-patients (four clinical and six laboratory-confirmed), two were hospitalized. In the case-control analysis of 71 inmate firefighters, frequently cutting fire lines with a McLeod tool (odds ratio [OR]: 5.5; 95% confidence interval [CI]: 1.1-37.2) and being in a dust cloud or storm (OR: 4.3; 95% CI: 1.1-17.4) were associated with illness. Two of 112 inmate firefighters reported receiving coccidioidomycosis training; none reported wearing respiratory protection on this wildfire. CONCLUSIONS Wildland firefighters who use hand tools and work in dusty conditions where Coccidioides proliferates are at risk for coccidioidomycosis. Agencies that employ them should provide training about coccidioidomycosis and risk reduction, limit dust exposure, and implement respiratory protection programs that specify where respirator use is feasible and appropriate.
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Affiliation(s)
- Rebecca L. Laws
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- California Department of Public Health, Richmond, California, USA
| | - Seema Jain
- California Department of Public Health, Richmond, California, USA
| | | | | | - Jennifer McNary
- California Department of Public Health, Richmond, California, USA
| | - Jason Wilken
- California Department of Public Health, Richmond, California, USA
- Office of Public Health Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- United States Public Health Service Commissioned Corps, Rockville, Maryland, USA
| | - Robert Harrison
- California Department of Public Health, Richmond, California, USA
| | - Bruce Leistikow
- California Correctional Health Care Services, Elk Grove, California, USA
| | - Duc J. Vugia
- California Department of Public Health, Richmond, California, USA
| | - Gayle C. Windham
- California Department of Public Health, Richmond, California, USA
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20
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Rosen HE, Kimura AC, Crandall J, Poe A, Nash J, Boetzer J, Tecle S, Mukhopadhyay R, Mcauley K, Kasirye O, Garza A, Shahkarami M, Chaturvedi V, Kiang D, Vidanes J, Mccoy K, Barcellos M, Derby T, Jain S, Vugia DJ. Foodborne Botulism Outbreak Associated With Commercial Nacho Cheese Sauce From a Gas Station Market. Clin Infect Dis 2021; 70:1695-1700. [PMID: 31247064 DOI: 10.1093/cid/ciz479] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 02/15/2019] [Accepted: 06/05/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Botulism is a rare and potentially fatal paralytic disease caused by botulinum neurotoxin (BoNT). In April 2017, 4 California residents from 2 adjacent counties were hospitalized with suspected foodborne botulism, precipitating an investigation by state and local public health departments in California. METHODS We interviewed suspected botulism patients and their families, inspected the suspect establishment, and collected suspect food. We tested patient sera, stool, and gastric aspirates using mouse bioassay for BoNT and/or culture for Clostridium botulinum. We tested suspect food and environmental samples for BoNT and confirmed presumptive positives using direct mouse bioassay and culture. We performed whole-genome sequencing on food and clinical isolates. RESULTS From April 2017 through May 2017, 10 patients in the Sacramento area were hospitalized with laboratory-confirmed botulism; 7 required mechanical ventilation, and 1 died. Of 9 patients with information, all had visited Gas Station X before illness onset, where 8 reported consuming a commercial cheese sauce. BoNT/A and/or BoNT/A-producing C. botulinum were detected from each patient and from leftover cheese sauce. Clostridium botulinum isolates from 4 patients were closely related to cheese sauce isolates by whole-genome high-quality single-nucleotide polymorphism analysis. No other botulism cases associated with this cheese sauce were reported elsewhere in the United States. CONCLUSIONS This large foodborne botulism outbreak in California was caused by consumption of commercial cheese sauce dispensed at a gas station market. The epidemiologic and laboratory evidence confirmed the cheese sauce as the outbreak source. The cheese sauce was likely locally contaminated, although the mechanism is unclear.
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Affiliation(s)
- Hilary E Rosen
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - Akiko C Kimura
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - John Crandall
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - Alyssa Poe
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - June Nash
- Sacramento County Department Public Health, Mather
| | - Jason Boetzer
- Sacramento County Environmental Management Department, Mather
| | - Selam Tecle
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - Rituparna Mukhopadhyay
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - Kate Mcauley
- Sacramento County Department Public Health, Mather
| | | | - Alvaro Garza
- San Joaquin County Department of Health Care Services, Stockton
| | - Mahtab Shahkarami
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - Vishnu Chaturvedi
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - David Kiang
- Division of Food, Drug, and Cannabis Safety, California Department of Public Health, Richmond and Sacramento
| | - Jeff Vidanes
- Division of Food, Drug, and Cannabis Safety, California Department of Public Health, Richmond and Sacramento
| | - Kelly Mccoy
- Sacramento County Environmental Management Department, Mather
| | - Mark Barcellos
- Sacramento County Environmental Management Department, Mather
| | - Tammy Derby
- Sacramento County Environmental Management Department, Mather
| | - Seema Jain
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
| | - Duc J Vugia
- Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento
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21
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Snyder RE, Feiszli T, Foss L, Messenger S, Fang Y, Barker CM, Reisen WK, Vugia DJ, Padgett KA, Kramer VL. West Nile virus in California, 2003-2018: A persistent threat. PLoS Negl Trop Dis 2020; 14:e0008841. [PMID: 33206634 PMCID: PMC7710070 DOI: 10.1371/journal.pntd.0008841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 03/18/2020] [Revised: 12/02/2020] [Accepted: 09/24/2020] [Indexed: 02/06/2023] Open
Abstract
The California Arbovirus Surveillance Program was initiated over 50 years ago to track endemic encephalitides and was enhanced in 2000 to include West Nile virus (WNV) infections in humans, mosquitoes, sentinel chickens, dead birds and horses. This comprehensive statewide program is a function of strong partnerships among the California Department of Public Health (CDPH), the University of California, and local vector control and public health agencies. This manuscript summarizes WNV surveillance data in California since WNV was first detected in 2003 in southern California. From 2003 through 2018, 6,909 human cases of WNV disease, inclusive of 326 deaths, were reported to CDPH, as well as 730 asymptomatic WNV infections identified during screening of blood and organ donors. Of these, 4,073 (59.0%) were reported as West Nile neuroinvasive disease. California's WNV disease burden comprised 15% of all cases that were reported to the U.S. Centers for Disease Control and Prevention during this time, more than any other state. Additionally, 1,299 equine WNV cases were identified, along with detections of WNV in 23,322 dead birds, 31,695 mosquito pools, and 7,340 sentinel chickens. Annual enzootic detection of WNV typically preceded detection in humans and prompted enhanced intervention to reduce the risk of WNV transmission. Peak WNV activity occurred from July through October in the Central Valley and southern California. Less than five percent of WNV activity occurred in other regions of the state or outside of this time. WNV continues to be a major threat to public and wild avian health in California, particularly in southern California and the Central Valley during summer and early fall months. Local and state public health partners must continue statewide human and mosquito surveillance and facilitate effective mosquito control and bite prevention measures.
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Affiliation(s)
- Robert E. Snyder
- California Department of Public Health, Vector-Borne Disease Section, Richmond and Sacramento, California, United States of America
| | - Tina Feiszli
- California Department of Public Health, Vector-Borne Disease Section, Richmond and Sacramento, California, United States of America
| | - Leslie Foss
- California Department of Public Health, Vector-Borne Disease Section, Richmond and Sacramento, California, United States of America
| | - Sharon Messenger
- California Department of Public Health, Division of Communicable Disease Control, Richmond, California, United States of America
| | - Ying Fang
- Department of Pathology, Microbiology & Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Christopher M. Barker
- Department of Pathology, Microbiology & Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - William K. Reisen
- Department of Pathology, Microbiology & Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Duc J. Vugia
- California Department of Public Health, Division of Communicable Disease Control, Richmond, California, United States of America
| | - Kerry A. Padgett
- California Department of Public Health, Vector-Borne Disease Section, Richmond and Sacramento, California, United States of America
| | - Vicki L. Kramer
- California Department of Public Health, Vector-Borne Disease Section, Richmond and Sacramento, California, United States of America
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Hurd-Kundeti G, Sondermeyer Cooksey GL, Jain S, Vugia DJ. Valley Fever (Coccidioidomycosis) Awareness - California, 2016-2017. MMWR Morb Mortal Wkly Rep 2020; 69:1512-1516. [PMID: 33090980 PMCID: PMC7583507 DOI: 10.15585/mmwr.mm6942a2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Valley fever (coccidioidomycosis) is endemic in the southwestern United States and caused by inhalation of Coccidioides spp. fungal spores from soil or dust; 97% of U.S. Valley fever cases are reported from Arizona and California (1). In California, Valley fever incidence increased 213% from 2014 to 2018 (2). In 2016, the California Department of Public Health (CDPH) added three questions to the adult California Behavioral Risk Factor Surveillance System (BRFSS) survey to better understand whether Californians had heard of Valley fever, knew the environmental risk where they live, and knew who is at risk for severe disease. A total of 2,893 BRFSS respondents aged ≥18 years answered at least one Valley fever question. Using the weighted California population, 42.4% of respondents reported general awareness of Valley fever; awareness was lowest among adults aged 18-44 years (32.9%) and Hispanic persons (26.4%). In addition, despite higher percentages reporting awareness of Valley fever, only 25.0% of persons living in a high-incidence region and 3.0% of persons living in a moderate-incidence region were aware that they lived in areas where Coccidioides spp. exist. Among persons with one or more risk factors for severe disease, 50.8% reported having heard about Valley fever, but only 3.5% knew they were at increased risk for severe disease. The findings from this survey helped to inform a statewide Valley fever awareness campaign implemented during 2019-2020 and to guide outreach to persons living in high- and moderate-incidence regions in California and potentially other southwestern states or who are at risk for severe disease.
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Affiliation(s)
- Glorietta Hurd-Kundeti
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health
| | - Gail L Sondermeyer Cooksey
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health
| | - Seema Jain
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health
| | - Duc J Vugia
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health
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23
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Tack DM, Ray L, Griffin PM, Cieslak PR, Dunn J, Rissman T, Jervis R, Lathrop S, Muse A, Duwell M, Smith K, Tobin-D’Angelo M, Vugia DJ, Zablotsky Kufel J, Wolpert BJ, Tauxe R, Payne DC. Preliminary Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2016-2019. MMWR Morb Mortal Wkly Rep 2020; 69:509-514. [PMID: 32352955 PMCID: PMC7206985 DOI: 10.15585/mmwr.mm6917a1] [Citation(s) in RCA: 152] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
To evaluate progress toward prevention of enteric illnesses, the Foodborne Diseases Active Surveillance Network (FoodNet) of CDC's Emerging Infections Program monitors the incidence of laboratory-diagnosed infections caused by eight pathogens transmitted commonly through food at 10 U.S. sites.* This report summarizes preliminary 2019 data and describes changes in incidence compared with that during 2016-2018. The incidence of enteric infections caused by these eight pathogens reported by FoodNet sites in 2019 continued to increase or remained unchanged, indicating progress in controlling major foodborne pathogens in the United States has stalled. Campylobacter and Salmonella caused the largest proportion of illnesses; trends in incidence varied by Salmonella serotype. Widespread adoption of whole genome sequencing (WGS) of bacteria has improved the ability to identify outbreaks, emerging strains, and sources of pathogens. To maximize the potential of WGS to link illnesses to particular sources, testing of isolates by clinical and public health laboratories is needed. Reductions in Salmonella serotype Typhimurium suggest that targeted interventions (e.g., vaccinating chickens and other food animals) might decrease human infections. Reducing contamination during food production, processing, and preparation will require more widespread implementation of known prevention measures and of new strategies that target particular pathogens and serotypes.
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Benedict K, McCotter OZ, Brady S, Komatsu K, Sondermeyer Cooksey GL, Nguyen A, Jain S, Vugia DJ, Jackson BR. Surveillance for Coccidioidomycosis - United States, 2011-2017. MMWR Surveill Summ 2019; 68:1-15. [PMID: 31538631 PMCID: PMC6756189 DOI: 10.15585/mmwr.ss6807a1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PROBLEM/CONDITION Coccidioidomycosis (Valley fever) is an infection caused by the environmental fungus Coccidioides spp., which typically causes respiratory illness but also can lead to disseminated disease. This fungus typically lives in soils in warm, arid regions, including the southwestern United States. REPORTING PERIOD 2011-2017. DESCRIPTION OF SYSTEM Coccidioidomycosis has been nationally notifiable since 1995 and is reportable in 26 states and the District of Columbia (DC), where laboratories and physicians notify local and state public health departments about possible coccidioidomycosis cases. Health department staff determine which cases qualify as confirmed cases according to the definition established by Council of State and Territorial Epidemiologists and voluntarily submit basic case information to CDC through the National Notifiable Diseases Surveillance System. RESULTS During 2011-2017, a total of 95,371 coccidioidomycosis cases from 26 states and DC were reported to CDC. The number of cases decreased from 2011 (22,634 cases) to 2014 (8,232 cases) and subsequently increased to 14,364 cases in 2017; >95% of cases were reported from Arizona and California. Reported incidence in Arizona decreased from 261 per 100,000 persons in 2011 to 101 in 2017, whereas California incidence increased from 15.7 to 18.2, and other state incidence rates stayed relatively constant. Patient demographic characteristics were largely consistent with previous years, with an overall predominance among males and among adults aged >60 years in Arizona and adults aged 40-59 years in California. INTERPRETATION Coccidioidomycosis remains an important national public health problem with a well-established geographic focus. The reasons for the changing trends in reported cases are unclear but might include environmental factors (e.g., temperature and precipitation), surveillance artifacts, land use changes, and changes in the population at risk for the infection. PUBLIC HEALTH ACTION Health care providers should consider a diagnosis of coccidioidomycosis in patients who live or work in or have traveled to areas with known geographic risk for Coccidioides and be aware that those areas might be broader than previously recognized. Coccidioidomycosis surveillance provides important information about the epidemiology of the disease but is incomplete both in terms of geographic coverage and data availability. Expanding surveillance to additional states could help identify emerging areas that pose a risk for locally acquired infections. In Arizona and California, where most cases occur, collecting systematic enhanced data, such as more detailed patient characteristics and disease severity, could help clarify the reasons behind the recent changes in incidence and identify additional opportunities for focused prevention and educational efforts.
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25
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Vugia DJ, Richardson J, Tarro T, Vareechon C, Pannaraj PS, Traub E, Cope JR, Balter S. Notes from the Field: Fatal Naegleria fowleri Meningoencephalitis After Swimming in Hot Spring Water - California, 2018. MMWR Morb Mortal Wkly Rep 2019; 68:793-794. [PMID: 31513557 PMCID: PMC6753969 DOI: 10.15585/mmwr.mm6836a3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Hurst S, Lysen C, Cooksey G, Vugia DJ, Litvintseva AP, Lockhart SR. Molecular typing of clinical and environmental isolates of Cryptococcus gattii species complex from southern California, United States. Mycoses 2019; 62:1029-1034. [PMID: 31376185 DOI: 10.1111/myc.12980] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 06/25/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Two species complexes (SC) cause the majority of human Cryptococcus infections: Cryptococcus neoformans SC and Cryptococcus gattii SC. Infection is typically thought to be acquired following environmental exposure. In an urban setting, parks and other public spaces are a likely source of contact with C. gattii SC. OBJECTIVES The goals of this study were to describe the genetic diversity of C. gattii SC in the California environment, to determine the extent of environmental exposure in publicly accessed areas and to correlate the genotypes of environmental C. gattii SC isolates with those from patients in southern California. METHODS Specimens from trees and soil from 13 parks and public areas of seven California counties were examined for C. gattii SC isolates. Isolates were sequence typed and compared to sequence types from human clinical isolates from the same area. RESULTS Multilocus sequence typing identified C. gattii sensu stricto (VGI molecular type) as well as Cryptococcus bacillisporus (VGIII molecular type). Several C. bacillisporus but none of the C. gattii sensu stricto isolates shared sequence types with human clinical isolates from southern California. CONCLUSIONS C. gattii SC colonies exist in some California public parks. The presence of identical STs in environmental and human isolates of C. bacillisporus is suggestive of an arboreal origin of human infections. Two new tree species were documented as hosts for C. gattii SC in California, adding to the four species previously identified.
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Affiliation(s)
- Steven Hurst
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Colleen Lysen
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gail Cooksey
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | - Duc J Vugia
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | | | - Shawn R Lockhart
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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28
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Tack DM, Marder EP, Griffin PM, Cieslak PR, Dunn J, Hurd S, Scallan E, Lathrop S, Muse A, Ryan P, Smith K, Tobin‐D'Angelo M, Vugia DJ, Holt KG, Wolpert BJ, Tauxe R, Geissler AL. Preliminary incidence and trends of infections with pathogens transmitted commonly through food — Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2015–2018. Am J Transplant 2019. [DOI: 10.1111/ajt.15412] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Danielle M. Tack
- Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control Atlanta Georgia
| | - Ellyn P. Marder
- Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control Atlanta Georgia
| | - Patricia M. Griffin
- Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control Atlanta Georgia
| | | | - John Dunn
- Tennessee Department of Health Nashville Tennessee
| | - Sharon Hurd
- Connecticut Department of Public Health Hartford Connecticut
| | | | | | - Alison Muse
- New York State Department of Health Albany New York
| | | | - Kirk Smith
- Minnesota Department of Health Saint Paul Minnesota
| | | | - Duc J. Vugia
- California Department of Public Health Sacramento California
| | - Kristin G. Holt
- Food Safety and Inspection Service U.S. Department of Agriculture AtlantaGeorgia
| | - Beverly J. Wolpert
- Center for Food Safety and Applied Nutrition Food and Drug Administration Silver Spring Maryland
| | - Robert Tauxe
- Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control Atlanta Georgia
| | - Aimee L. Geissler
- Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control Atlanta Georgia
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29
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Tack DM, Marder EP, Griffin PM, Cieslak PR, Dunn J, Hurd S, Scallan E, Lathrop S, Muse A, Ryan P, Smith K, Tobin-D'Angelo M, Vugia DJ, Holt KG, Wolpert BJ, Tauxe R, Geissler AL. Preliminary Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2015-2018. MMWR Morb Mortal Wkly Rep 2019; 68:369-373. [PMID: 31022166 PMCID: PMC6483286 DOI: 10.15585/mmwr.mm6816a2] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Porse CC, Messenger S, Vugia DJ, Jilek W, Salas M, Watt J, Kramer V. Travel-Associated Zika Cases and Threat of Local Transmission during Global Outbreak, California, USA. Emerg Infect Dis 2019; 24:1626-1632. [PMID: 30124194 PMCID: PMC6106427 DOI: 10.3201/eid2409.180203] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Zika and associated microcephaly among newborns were reported in Brazil during 2015. Zika has since spread across the Americas, and travel-associated cases were reported throughout the United States. We reviewed travel-associated Zika cases in California to assess the potential threat of local Zika virus transmission, given the regional spread of Aedes aegypti and Ae. albopictus mosquitoes. During November 2015-September 2017, a total of 588 travel-associated Zika cases were reported in California, including 139 infections in pregnant women, 10 congenital infections, and 8 sexually transmitted infections. Most case-patients reported travel to Mexico and Central America, and many returned during a period when they could have been viremic. By September 2017, Ae. aegypti mosquitoes had spread to 124 locations in California, and Ae. albopictus mosquitoes had spread to 53 locations. Continued human and mosquito surveillance and public health education are valuable tools in preventing and detecting Zika virus infections and local transmission in California.
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31
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de Perio MA, Materna BL, Sondermeyer Cooksey GL, Vugia DJ, Su CP, Luckhaupt SE, McNary J, Wilken JA. Occupational coccidioidomycosis surveillance and recent outbreaks in California. Med Mycol 2019; 57:S41-S45. [PMID: 30690596 DOI: 10.1093/mmy/myy031] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/01/2018] [Indexed: 01/06/2023] Open
Abstract
Workers in Coccidioides-endemic areas performing soil-disturbing work or exposed to windy and dusty conditions are at increased risk for coccidioidomycosis. Four occupational coccidioidomycosis outbreaks from 2007 to 2014 in California are described, involving construction workers in a number of excavation projects and an outdoor filming event involving cast and crew. These outbreaks highlight the importance of identifying industries and occupations at high risk for coccidioidomycosis, conducting targeted occupational health surveillance to assess the burden of illness, developing and implementing prevention strategies, and setting research priorities.
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Affiliation(s)
- Marie A de Perio
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA.,United States Public Health Service Commissioned Corps, Rockville, Maryland, USA
| | - Barbara L Materna
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
| | | | - Duc J Vugia
- Infectious Diseases Branch, California Department of Public Health, Richmond, California, USA
| | - Chia-Ping Su
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Sara E Luckhaupt
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA.,United States Public Health Service Commissioned Corps, Rockville, Maryland, USA
| | - Jennifer McNary
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
| | - Jason A Wilken
- United States Public Health Service Commissioned Corps, Rockville, Maryland, USA.,Occupational Health Branch, California Department of Public Health, Richmond, California, USA.,Career Epidemiology Field Officer, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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32
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Sondermeyer Cooksey GL, Jain S, Vugia DJ. Epidemiology of coccidioidomycosis among children in California, 2000-2016. Med Mycol 2019; 57:S64-S66. [PMID: 30690598 DOI: 10.1093/mmy/myy066] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/30/2018] [Indexed: 11/13/2022] Open
Abstract
We calculated population-based incidence of coccidioidomycosis from the 2000-2016 California surveillance data and compared children (≤17 years) with adults (≥18 years). During that time, the annual pediatric incidence per 100,000 increased from 0.8 in 2000 to 5.2 in 2016, while the adult annual rate increased from 3.2 in 2000 to 16.2 in 2016. Pediatric incidence was higher among children in the 12-17-year age group and among residents of endemic counties. Rates by sex were similar from infancy until adolescence when rates in males became substantially higher than females and remained so into older age; reasons for this are unclear.
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Affiliation(s)
| | - Seema Jain
- Infectious Diseases Branch, California Department of Public Health, Richmond, California
| | - Duc J Vugia
- Infectious Diseases Branch, California Department of Public Health, Richmond, California
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Pohl AM, Pouillot R, Bazaco MC, Wolpert BJ, Healy JM, Bruce BB, Laughlin ME, Hunter JC, Dunn JR, Hurd S, Rowlands JV, Saupe A, Vugia DJ, Van Doren JM. Differences Among Incidence Rates of Invasive Listeriosis in the U.S. FoodNet Population by Age, Sex, Race/Ethnicity, and Pregnancy Status, 2008-2016. Foodborne Pathog Dis 2019; 16:290-297. [PMID: 30735066 PMCID: PMC6482898 DOI: 10.1089/fpd.2018.2548] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 11/13/2022] Open
Abstract
Listeria monocytogenes is a foodborne pathogen that disproportionally affects pregnant females, older adults, and immunocompromised individuals. Using U.S. Foodborne Diseases Active Surveillance Network (FoodNet) surveillance data, we examined listeriosis incidence rates and rate ratios (RRs) by age, sex, race/ethnicity, and pregnancy status across three periods from 2008 to 2016, as recent incidence trends in U.S. subgroups had not been evaluated. The invasive listeriosis annual incidence rate per 100,000 for 2008-2016 was 0.28 cases among the general population (excluding pregnant females), and 3.73 cases among pregnant females. For adults ≥70 years, the annual incidence rate per 100,000 was 1.33 cases. No significant change in estimated listeriosis incidence was found over the 2008-2016 period, except for a small, but significantly lower pregnancy-associated rate in 2011-2013 when compared with 2008-2010. Among the nonpregnancy-associated cases, RRs increased with age from 0.43 (95% confidence interval: 0.25-0.73) for 0- to 14-year olds to 44.9 (33.5-60.0) for ≥85-year olds, compared with 15- to 44-year olds. Males had an incidence of 1.28 (1.12-1.45) times that of females. Compared with non-Hispanic whites, the incidence was 1.57 (1.18-1.20) times higher among non-Hispanic Asians, 1.49 (1.22-1.83) among non-Hispanic blacks, and 1.73 (1.15-2.62) among Hispanics. Among females of childbearing age, non-Hispanic Asian females had 2.72 (1.51-4.89) and Hispanic females 3.13 (2.12-4.89) times higher incidence than non-Hispanic whites. We observed a higher percentage of deaths among older patient groups compared with 15- to 44-year olds. This study is the first characterizing higher RRs for listeriosis in the United States among non-Hispanic blacks and Asians compared with non-Hispanic whites. This information for public health risk managers may spur further research to understand if differences in listeriosis rates relate to differences in consumption patterns of foods with higher contamination levels, food handling practices, comorbidities, immunodeficiencies, health care access, or other factors.
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Affiliation(s)
- Aurelie M. Pohl
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland
| | - Régis Pouillot
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland
| | - Michael C. Bazaco
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland
| | - Beverly J. Wolpert
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland
| | - Jessica M. Healy
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Beau B. Bruce
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark E. Laughlin
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer C. Hunter
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John R. Dunn
- Tennessee Department of Health, Nasvhille, Tennessee
| | - Sharon Hurd
- Connecticut Emerging Infections Program, Yale University School of Public Health, New Haven, Connecticut
| | | | - Amy Saupe
- Minnesota Department of Health, Saint Paul, Minnesota
| | - Duc J. Vugia
- California Department of Public Health, Sacramento, California
| | - Jane M. Van Doren
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland
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Marder Mph EP, Griffin PM, Cieslak PR, Dunn J, Hurd S, Jervis R, Lathrop S, Muse A, Ryan P, Smith K, Tobin-D'Angelo M, Vugia DJ, Holt KG, Wolpert BJ, Tauxe R, Geissler AL. Preliminary Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2006-2017. MMWR Morb Mortal Wkly Rep 2018; 67:324-328. [PMID: 29565841 PMCID: PMC5868202 DOI: 10.15585/mmwr.mm6711a3] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Abstract
The number of cases of coccidioidomycosis and associated hospitalizations increased in California during 2000-2013. During that period, a total of 1,098 death records listed coccidioidomycosis as a cause, averaging 78 deaths annually (range: 43-108). The death rate peaked in 2006 and was significantly higher among males than among females, among African American patients than among white patients, and among residents of the coccidioidomycosis-endemic region of California than among residents of the less endemic regions (p<0.001). A higher death rate was associated with increasing age and was highest (8.8 per 1 million population) among adults aged ≥75 years. Of coccidioidomycosis-associated deaths, 31.9% had a contributing cause of death of severe/disseminated disease, 31.8% of unspecified -coccidioidomycosis, and 28.3% of pulmonary unspecified coccidioidomycosis, per International Classification of Diseases codes. Diabetes was a contributing cause in 19.3% of deaths, and other immunocompromising conditions were a contributing cause in 15.9% of deaths. Populations at higher risk for coccidioidomycosis--associated deaths are similar to those at higher risk for coccidioidomycosis-associated hospitalizations and infection. Awareness for coccidioidomycosis among these groups and their providers is important for proper diagnosis and care.
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Affiliation(s)
- Gail L Sondermeyer
- California Department of Public Health, Infectious Diseases Branch, Richmond, CA
| | - Lauren A Lee
- California Department of Public Health, Infectious Diseases Branch, Richmond, CA
| | - Debra Gilliss
- California Department of Public Health, Infectious Diseases Branch, Richmond, CA
| | - Duc J Vugia
- California Department of Public Health, Infectious Diseases Branch, Richmond, CA
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Sondermeyer Cooksey GL, Wilken JA, McNary J, Gilliss D, Shusterman D, Materna BL, Vugia DJ. Dust Exposure and Coccidioidomycosis Prevention Among Solar Power Farm Construction Workers in California. Am J Public Health 2017. [PMID: 28640687 DOI: 10.2105/ajph.2017.303820] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate if work activities, dust exposure, and protection measures were associated with a 2011 to 2014 coccidioidomycosis outbreak among workers constructing 2 solar farms in California. METHODS In 2013, we mailed self-administered questionnaires to employees who were onsite at the solar farms where the outbreak occurred to identify cases of clinical coccidioidomycosis and compare with asymptomatic workers by using multivariate logistic regression. RESULTS When we compared 89 workers with clinical coccidioidomycosis to 325 asymptomatic workers, frequently being in a dust cloud or storm (odds ratio [OR] = 5.93; 95% confidence interval [CI] = 3.18, 11.06) significantly increased the odds of clinical coccidioidomycosis, whereas frequently wetting soil before soil-disturbing activity (OR = 0.42; 95% CI = 0.24, 0.75) was protective. When we controlled for being in a dust cloud or storm, frequent soil disturbance significantly increased the odds of clinical coccidioidomycosis only among those who reported wearing a respirator infrequently (OR = 2.31; 95% CI = 1.27, 4.21). CONCLUSIONS Utilization of personal and employer-driven safety practices and increased coccidioidomycosis awareness among construction workers should be considered during the planning of any construction work in coccidioidomycosis-endemic regions to prevent occupational infections and outbreaks.
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Affiliation(s)
- Gail L Sondermeyer Cooksey
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jason A Wilken
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jennifer McNary
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Debra Gilliss
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dennis Shusterman
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Barbara L Materna
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Duc J Vugia
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
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Marder EP, Cieslak PR, Cronquist AB, Dunn J, Lathrop S, Rabatsky-Ehr T, Ryan P, Smith K, Tobin-D’Angelo M, Vugia DJ, Zansky S, Holt KG, Wolpert BJ, Lynch M, Tauxe R, Geissler AL. Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food and the Effect of Increasing Use of Culture-Independent Diagnostic Tests on Surveillance - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2013-2016. MMWR Morb Mortal Wkly Rep 2017; 66:397-403. [PMID: 28426643 PMCID: PMC5687182 DOI: 10.15585/mmwr.mm6615a1] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Lamba K, Nelson JA, Kimura AC, Poe A, Collins J, Kao AS, Cruz L, Inami G, Vaishampayan J, Garza A, Chaturvedi V, Vugia DJ. Shiga Toxin 1-Producing Shigella sonnei Infections, California, United States, 2014-2015. Emerg Infect Dis 2016; 22:679-86. [PMID: 26982255 PMCID: PMC4806944 DOI: 10.3201/eid2204.151825] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Shiga toxins (Stx) are primarily associated with Shiga toxin–producing Escherichia coli and Shigella dysenteriae serotype 1. Stx production by other shigellae is uncommon, but in 2014, Stx1-producing S. sonnei infections were detected in California. Surveillance was enhanced to test S. sonnei isolates for the presence and expression of stx genes, perform DNA subtyping, describe clinical and epidemiologic characteristics of case-patients, and investigate for sources of infection. During June 2014–April 2015, we identified 56 cases of Stx1-producing S. sonnei, in 2 clusters. All isolates encoded stx1 and produced active Stx1. Multiple pulsed-field gel electrophoresis patterns were identified. Bloody diarrhea was reported by 71% of case-patients; none had hemolytic uremic syndrome. Some initial cases were epidemiologically linked to travel to Mexico, but subsequent infections were transmitted domestically. Continued surveillance of Stx1-producing S. sonnei in California is necessary to characterize its features and plan for reduction of its spread in the United States.
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Wilken JA, Sondermeyer G, Shusterman D, McNary J, Vugia DJ, McDowell A, Borenstein P, Gilliss D, Ancock B, Prudhomme J, Gold D, Windham GC, Lee L, Materna BL. Coccidioidomycosis among Workers Constructing Solar Power Farms, California, USA, 2011-2014. Emerg Infect Dis 2016; 21:1997-2005. [PMID: 26484688 PMCID: PMC4622237 DOI: 10.3201/eid2111.150129] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Coccidioidomycosis is associated with soil-disruptive work in Coccidioides-endemic areas of the southwestern United States. Among 3,572 workers constructing 2 solar power-generating facilities in San Luis Obispo County, California, USA, we identified 44 patients with symptom onset during October 2011-April 2014 (attack rate 1.2 cases/100 workers). Of these 44 patients, 20 resided in California outside San Luis Obispo County and 10 resided in another state; 9 were hospitalized (median 3 days), 34 missed work (median 22 days), and 2 had disseminated disease. Of the 25 patients who frequently performed soil-disruptive work, 6 reported frequent use of respiratory protection. As solar farm construction in Coccidioides-endemic areas increases, additional workers will probably be exposed and infected unless awareness is emphasized and effective exposure reduction measures implemented, including limiting dust generation and providing respiratory protection. Medical providers, including those in non-Coccidioides-endemic areas, should suspect coccidioidomycosis in workers with compatible illness and report cases to their local health department.
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Vugia DJ, Meek JI, Danila RN, Jones TF, Schaffner W, Baumbach J, Lathrop S, Farley MM, Tobin-D'Angelo M, Miller L, Harrison LH, Bennett NM, Cieslak PR, Cartter ML, Reingold AL. Training in Infectious Disease Epidemiology through the Emerging Infections Program Sites. Emerg Infect Dis 2016; 21:1516-9. [PMID: 26291924 PMCID: PMC4550163 DOI: 10.3201/eid2109.150443] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 11/26/2022] Open
Abstract
EIP sites contribute substantially to training current and future public health professionals. One objective of the Emerging Infections Program (EIP) of the US Centers for Disease Control and Prevention is to provide training opportunities in infectious disease epidemiology. To determine the extent of training performed since the program's inception in 1995, we reviewed training efforts at the 10 EIP sites. By 2015, all sites hosted trainees (most were graduate public health students and physicians) who worked on a variety of infectious disease surveillance and epidemiologic projects. Trainee projects at all sites were used for graduate student theses or practicums. Numerous projects resulted in conference presentations and publications in peer-reviewed journals. Local public health and health care partners have also benefitted from EIP presentations and training. Consideration should be given to standardizing and documenting EIP training and to sharing useful training initiatives with other state and local health departments and academic institutions.
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Abstract
The Emerging Infections Program (EIP), a collaboration between (currently) 10 state health departments, their academic center partners, and the Centers for Disease Control and Prevention, was established in 1995. The EIP performs active, population-based surveillance for important infectious diseases, addresses new problems as they arise, emphasizes projects that lead to prevention, and develops and evaluates public health practices. The EIP has increasingly addressed the health equity challenges posed by Healthy People 2020. These challenges include objectives to increase the proportion of Healthy People-specified conditions for which national data are available by race/ethnicity and socioeconomic status as a step toward first recognizing and subsequently eliminating health inequities. EIP has made substantial progress in moving from an initial focus on monitoring social determinants exclusively through collecting and analyzing data by race/ethnicity to identifying and piloting ways to conduct population-based surveillance by using area-based socioeconomic status measures.
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Hadler JL, Danila RN, Cieslak PR, Meek JI, Schaffner W, Smith KE, Cartter ML, Harrison LH, Vugia DJ, Lynfield R. Emerging Infections Program--State Health Department Perspective. Emerg Infect Dis 2016; 21:1510-5. [PMID: 26289952 PMCID: PMC4550133 DOI: 10.3201/eid2109.150428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The Emerging Infections Program (EIP) is a collaboration between the Centers for Disease Control and Prevention and 10 state health departments working with academic partners to conduct active population-based surveillance and special studies for several emerging infectious disease issues determined to need special attention. The Centers for Disease Control and Prevention funds the 10 EIP sites through cooperative agreements. Our objective was to highlight 1) what being an EIP site has meant for participating health departments and associated academic centers, including accomplishments and challenges, and 2) the synergy between the state and federal levels that has resulted from the collaborative relationship. Sharing these experiences should provide constructive insight to other public health programs and other countries contemplating a collaborative federal-local approach to collective public health challenges.
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Abstract
FoodNet has provided a foundation for food safety policy and illness prevention since 1996. The Foodborne Diseases Active Surveillance Network (FoodNet) provides a foundation for food safety policy and illness prevention in the United States. FoodNet conducts active, population-based surveillance at 10 US sites for laboratory-confirmed infections of 9 bacterial and parasitic pathogens transmitted commonly through food and for hemolytic uremic syndrome. Through FoodNet, state and federal scientists collaborate to monitor trends in enteric illnesses, identify their sources, and implement special studies. FoodNet’s major contributions include establishment of reliable, active population-based surveillance of enteric diseases; development and implementation of epidemiologic studies to determine risk and protective factors for sporadic enteric infections; population and laboratory surveys that describe the features of gastrointestinal illnesses, medical care–seeking behavior, frequency of eating various foods, and laboratory practices; and development of a surveillance and research platform that can be adapted to address emerging issues. The importance of FoodNet’s ongoing contributions probably will grow as clinical, laboratory, and informatics technologies continue changing rapidly.
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Porse CC, Kramer V, Yoshimizu MH, Metzger M, Hu R, Padgett K, Vugia DJ. Public Health Response to Aedes aegypti and Ae. albopictus Mosquitoes Invading California, USA. Emerg Infect Dis 2016. [PMID: 26401891 PMCID: PMC4593441 DOI: 10.3201/eid2110.150494] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 11/24/2022] Open
Abstract
Aedes aegypti and Ae. albopictus mosquitoes, primary vectors of dengue and chikungunya viruses, were recently detected in California, USA. The threat of potential local transmission of these viruses increases as more infected travelers arrive from affected areas. Public health response has included enhanced human and mosquito surveillance, education, and intensive mosquito control.
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Porse CC, Kramer V, Yoshimizu MH, Metzger M, Hu R, Padgett K, Vugia DJ. Public Health Response to Aedes aegypti and Ae. albopictus Mosquitoes Invading California, USA. Emerg Infect Dis 2016; 21:1827-9. [PMID: 26401891 DOI: 10.3201/3210.150494] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 11/19/2022] Open
Abstract
Aedes aegypti and Ae. albopictus mosquitoes, primary vectors of dengue and chikungunya viruses, were recently detected in California, USA. The threat of potential local transmission of these viruses increases as more infected travelers arrive from affected areas. Public health response has included enhanced human and mosquito surveillance, education, and intensive mosquito control.
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Huang JY, Henao OL, Griffin PM, Vugia DJ, Cronquist AB, Hurd S, Tobin-D’Angelo M, Ryan P, Smith K, Lathrop S, Zansky S, Cieslak PR, Dunn J, Holt KG, Wolpert BJ, Patrick ME. Infection with Pathogens Transmitted Commonly Through Food and the Effect of Increasing Use of Culture-Independent Diagnostic Tests on Surveillance — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2012–2015. MMWR Morb Mortal Wkly Rep 2016; 65:368-71. [DOI: 10.15585/mmwr.mm6514a2] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Hadler JL, Vugia DJ, Bennett NM, Moore MR. Emerging Infections Program Efforts to Address Health Equity. Emerg Infect Dis 2015. [DOI: 10.3201/2109.150275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Núñez JJ, Fritz CL, Knust B, Buttke D, Enge B, Novak MG, Kramer V, Osadebe L, Messenger S, Albariño CG, Ströher U, Niemela M, Amman BR, Wong D, Manning CR, Nichol ST, Rollin PE, Xia D, Watt JP, Vugia DJ. Hantavirus infections among overnight visitors to Yosemite National Park, California, USA, 2012. Emerg Infect Dis 2015; 20:386-93. [PMID: 24565589 PMCID: PMC3944872 DOI: 10.3201/eid2003.131581] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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
TOC summary: A rare hantavirus outbreak reaffirms the need for control of deer mice and public awareness of the risks posed by contact with them. In summer 2012, an outbreak of hantavirus infections occurred among overnight visitors to Yosemite National Park in California, USA. An investigation encompassing clinical, epidemiologic, laboratory, and environmental factors identified 10 cases among residents of 3 states. Eight case-patients experienced hantavirus pulmonary syndrome, of whom 5 required intensive care with ventilatory support and 3 died. Staying overnight in a signature tent cabin (9 case-patients) was significantly associated with becoming infected with hantavirus (p<0.001). Rodent nests and tunnels were observed in the foam insulation of the cabin walls. Rodent trapping in the implicated area resulted in high trap success rate (51%), and antibodies reactive to Sin Nombre virus were detected in 10 (14%) of 73 captured deer mice. All signature tent cabins were closed and subsequently dismantled. Continuous public awareness and rodent control and exclusion are key measures in minimizing the risk for hantavirus infection in areas inhabited by deer mice.
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Rosenberg J, Jarvis WR, Abbott SL, Vugia DJ. Emergence of Vancomycin-Resistant Enterococci in San Francisco Bay Area Hospitals During 1994 to 1998. Infect Control Hosp Epidemiol 2015; 25:408-12. [PMID: 15188847 DOI: 10.1086/502414] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractObjective:To determine the magnitude of van-comycin-resistant enterococci (VRE) in three counties in the San Francisco Bay area.Design:Active laboratory-based surveillance for VRE from January 1995 through December 1996 and a laboratory-based and hospital-based questionnaire survey for 1993 to 1994 and 1997 to 1998.Setting:All 33 general acute care hospitals in three counties in the San Francisco Bay area.Participants:Laboratories and infection control professionals serving these hospitals, and staff of the California Emerging Infections Program.Results:The number of hospitals reporting 1 or more patient clinical VRE isolates was 1 (3%) in 1993, 7 (21%) in 1994, 31 (94%) in 1995, and 33 (100%) in 1996 to 1998. The number of patient isolates increased from 1 in 1993 to 24 in 1994, 176 in 1995,429 in 1996, 730 in 1997, and 864 in 1998. Most VRE isolates in 1995 and 1996 were from urine and were not associated with serious clinical disease. However, the number of isolates from blood increased from 9 (6% of total) in 1995 to 44 (12% of the total) in 1996, 90 (14%) in 1997, and 100 (13%) in 1998.Conclusions:Our data document the rapid emergence and increase of VRE in all hospitals in three counties in the San Francisco Bay area during 1994 to 1998. Infection control measures for VRE together with antibiotic utilization programs should be implemented to limit further spread.
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Affiliation(s)
- Jon Rosenberg
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Health Services, 2151 Berkeley Way, Berkeley, CA 94704, USA
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Mortensen E, Trivedi KK, Rosenberg J, Cody SH, Long J, Jensen BJ, Vugia DJ. Multidrug-resistant Acinetobacter baumannii infection, colonization, and transmission related to a long-term care facility providing subacute care. Infect Control Hosp Epidemiol 2014; 35:406-11. [PMID: 24602946 DOI: 10.1086/675612] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To investigate Acinetobacter baumannii infection, colonization, and transmission related to a long-term care facility (LTCF) providing subacute care (facility A). METHODS We reviewed facility A and affiliated local hospital records for facility A residents with A. baumannii isolated during the period January 2009 through February 2010 and compared A. baumannii antimicrobial resistance patterns of residents with those of hospital patients. During March 2010, we implemented a colonization survey of facility A residents who received respiratory support or who could provide sputum samples and looked for A. baumannii colonization risks. Available clinical and survey isolates underwent pulsed-field gel electrophoresis (PFGE); PFGE strains were linked with overlapping stays to identify possible transmission. RESULTS During the period January 2009 through February 2010, 33 facility A residents had A. baumannii isolates; all strains were multidrug resistant (MDR), which was a significantly higher prevalence of MDR strains than that found among isolates from hospital patients (81 [66%] of 122 hospital patient isolates were MDR; P < .001). The sputum survey found that 14 (20%) of 70 residents had A. baumannii colonization, which was associated with ventilator use (adjusted odds ratio, 4.24 [95% confidence interval, 1.06-16.93]); 12 (86%) of 14 isolates were MDR. Four facility A resident groups clustered with 3 PFGE strains and overlapping stays. One of these facility A residents also clustered with 3 patients at an affiliated hospital. CONCLUSIONS We documented substantial MDR A. baumannii infections and colonization with probable intra- and interfacility spread associated with a single LTCF providing subacute care. Given the limited infection prevention and antimicrobial stewardship resources in such settings, regional collaborations among facilities across the spectrum of health care are needed to address this MDR threat.
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Affiliation(s)
- Eva Mortensen
- Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California
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