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Koralur M, Chen CY, Pillay A, White B, Pettus K, Chi KH, Stringer J, Aroh C, Dasu T, Bhattacharyya S, Perkins K, Chen J, Riner D, Soehnlen M, Cao W, Gaynor AM, Kersh EN. Evaluation of a laboratory-developed multiplex real-time PCR assay for diagnosis of syphilis, herpes and chancroid genital ulcers in four public health laboratories in the USA. Sex Transm Infect 2021; 98:448-450. [PMID: 34873027 DOI: 10.1136/sextrans-2021-055081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/25/2021] [Accepted: 11/08/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate the field performance of a multiplex PCR (M-PCR) assay for detection of herpes simplex virus (HSV)-1 and HSV-2, Treponema pallidum (T. pallidum) and Haemophilus ducreyi (H. ducreyi) in genital ulcer disease (GUD) specimens. METHODS GUD M-PCR was performed on 186 remnant specimens, previously collected for HSV testing, by four public health laboratories (PHLs) and the Laboratory Reference and Research Branch (LRRB) at the Centers for Disease Control and Prevention. The results from the PHLs were compared with those of LRRB, which served as the reference testing method, and percentage agreement was calculated. RESULTS HSV was detected in 31 of 52 (59.6%), 20 of 40 (50%), 43 of 44 (97.7%) and 19 of 50 (38.0%) specimens from PHL1, PHL2, PHL3 and PHL4, respectively. There were seven discrepant results for HSV, and the overall percent agreement between the PHLs and the LRRB was 94%-100%, with a kappa value of 0.922, which demonstrates high agreement. T. pallidum was identified in 7 of 51 (13.7%) specimens from PHL1 with 94.1% agreement and in 2 of 40 (5.0%) specimens from PHL2 with 100% agreement. The LRRB identified three additional T. pallidum-positive specimens from PHL1. The kappa value (0.849) for T. pallidum testing suggests good agreement. Consistent with the LRRB results, no T. pallidum was detected in specimens from PHL3 and PHL4, and H. ducreyi was not detected at any of the study sites. CONCLUSIONS The GUD M-PCR assay performed well in four independent PHLs and 12 suspected syphilis cases were identified in this study. The M-PCR assay could provide improved diagnostic options for GUD infections in state and local PHLs.
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Affiliation(s)
- Munegowda Koralur
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA .,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Cheng Y Chen
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Allan Pillay
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brunie White
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kevin Pettus
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kai-Hua Chi
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Joey Stringer
- Dallas County Health and Human Services, Dallas, Texas, USA
| | | | - Trivikram Dasu
- City of Milwaukee Health Department Laboratory, Milwaukee, Wisconsin, USA
| | | | - Keith Perkins
- Maryland Department of Health, Baltimore, Maryland, USA
| | - Jenny Chen
- Maryland Department of Health, Baltimore, Maryland, USA
| | - Diana Riner
- Michigan Department of Health and Human Services Bureau of Laboratories, Lansing, Michigan, USA
| | - Marty Soehnlen
- Michigan Department of Health and Human Services Bureau of Laboratories, Lansing, Michigan, USA
| | - Weiping Cao
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anne M Gaynor
- Association of Public Health Laboratories, Silver Spring, Maryland, USA
| | - Ellen N Kersh
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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6
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McClung RP, Karwowski M, Castillo C, McFadden J, Collier S, Collins J, Soehnlen M, Dietrich S, Trees E, Wilt G, Harrington C, Miller A, Adam E, Reses H, Cope J, Fullerton K, Hill V, Yoder J. Shigella sonnei Outbreak Investigation During a Municipal Water Crisis-Genesee and Saginaw Counties, Michigan, 2016. Am J Public Health 2020; 110:842-849. [PMID: 32298181 DOI: 10.2105/ajph.2020.305577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objectives. To investigate a shigellosis outbreak in Genesee County, Michigan (including the City of Flint), and Saginaw County, Michigan, in 2016 and address community concerns about the role of the Flint water system.Methods. We met frequently with community members to understand concerns and develop the investigation. We surveyed households affected by the outbreak, analyzed Shigella isolate data, examined the geospatial distribution of cases, and reviewed available water quality data.Results. We surveyed 83 households containing 158 cases; median age was 10 years. Index case-patients from 55 of 83 households (66%) reported contact with a person outside their household who wore diapers or who had diarrhea in the week before becoming ill; results were similar regardless of household drinking water source. Genomic diversity was not consistent with a point source. In Flint, no space-time clustering was identified, and average free chlorine residual values remained above recommended levels throughout the outbreak period.Conclusions. The outbreak was most likely caused by person-to-person contact and not by the Flint water system. Consistent community engagement was essential to the design and implementation of the investigation.
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Affiliation(s)
- R Paul McClung
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Mateusz Karwowski
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Caroline Castillo
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Jevon McFadden
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Sarah Collier
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Jim Collins
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Marty Soehnlen
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Stephen Dietrich
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Eija Trees
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Grete Wilt
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Christina Harrington
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Ashley Miller
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Elizabeth Adam
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Hannah Reses
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Jennifer Cope
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Katie Fullerton
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Vincent Hill
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
| | - Jonathan Yoder
- R. Paul McClung and Caroline Castillo are with the Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Mateusz Karwowski, Sarah Collier, Eija Trees, Elizabeth Adam, Hannah Reses, Jennifer Cope, Katie Fullerton, Vincent Hill, and Jonathan Yoder are with the Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. Jevon McFadden, Jim Collins, and Ashley Miller are with the Michigan Department of Health and Human Services, Lansing. Marty Soehnlen and Stephen Dietrich are with the Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing. Grete Wilt is with the Division of Toxicology and Human Health Sciences, Geospatial Research, Analysis, and Services Program (GRASP), CDC, Atlanta. Christina Harrington is with the Saginaw County Health Department, Saginaw, MI
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7
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Robertson SA, Sidge JL, Koski L, Hardy MC, Stevenson L, Signs K, Stobierski MG, Bidol S, Donovan D, Soehnlen M, Jones K, Robeson S, Hambley A, Stefanovsky L, Brandenburg J, Hise K, Tolar B, Nichols MC, Basler C. Onsite investigation at a mail-order hatchery following a multistate Salmonella illness outbreak linked to live poultry-United States, 2018. Poult Sci 2019; 98:6964-6972. [PMID: 31579916 PMCID: PMC6870551 DOI: 10.3382/ps/pez529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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] [Received: 04/25/2019] [Accepted: 09/26/2019] [Indexed: 12/04/2022] Open
Abstract
Centers for Disease Control and Prevention (CDC), health departments, and other state and federal partners have linked contact with live poultry to 70 human Salmonella outbreaks in the United States from 2000 to 2017, which resulted in a total of 4,794 illnesses, 894 hospitalizations, and 7 deaths. During human salmonellosis outbreaks environmental sampling is rarely conducted as part of the outbreak investigation. CDC was contacted by state health officials on June 12, 2018, to provide support during an investigation of risk factors for Salmonella infections linked to live poultry originating at a mail-order hatchery. From January 1, 2018, to June 15, 2018, 13 human Salmonella infections in multiple states were attributed to exposure to live poultry from a single hatchery. Two serotypes of Salmonella were associated with these infections, Salmonella Enteritidis and Salmonella Litchfield. Molecular subtyping of the S. Enteritidis clinical isolates revealed they were closely related genetically (within 0 to 9 alleles) by core genome multi-locus sequence typing (cgMLST) to isolates obtained from environmental samples taken from hatchery shipping containers received at retail outlets. Environmental sampling and onsite investigation of practices was conducted at the mail-order hatchery during an investigation on June 19, 2018. A total of 45 environmental samples were collected, and 4 (9%) grew Salmonella. A chick box liner from a box in the pre-shipping area yielded an isolate closely related to the S. Enteritidis outbreak strain (within 1 to 9 alleles by cgMLST). The onsite investigation revealed lapses in biosecurity, sanitation, quality assurance, and education of consumers. Review of Salmonella serotype testing performed by the hatchery revealed that the number of samples and type of samples collected monthly varied. Also, S. Enteritidis was identified at the hatchery every year since testing began in 2016. Recommendations to the hatchery for biosecurity, testing, and sanitation measures were made to help reduce burden of Salmonella in the hatchery and breeding flocks, thereby reducing the occurrence of human illness.
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Affiliation(s)
- Scott A Robertson
- Epidemic Intelligence Service, CDC, Atlanta GA, 30333, United States
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
| | - Jennifer L Sidge
- Bureau of Epidemiology and Population Health, Michigan Department of Health and Human Services, Lansing, MI 48909, United States
| | - Lia Koski
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
| | - Margaret C Hardy
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
- Laboratory Leadership Service, CDC, Atlanta, GA 30333, United States
| | - Lauren Stevenson
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
| | - Kimberly Signs
- Bureau of Epidemiology and Population Health, Michigan Department of Health and Human Services, Lansing, MI 48909, United States
| | - Mary Grace Stobierski
- Bureau of Epidemiology and Population Health, Michigan Department of Health and Human Services, Lansing, MI 48909, United States
| | - Sally Bidol
- Bureau of Epidemiology and Population Health, Michigan Department of Health and Human Services, Lansing, MI 48909, United States
| | - Danielle Donovan
- Bureau of Epidemiology and Population Health, Michigan Department of Health and Human Services, Lansing, MI 48909, United States
| | - Marty Soehnlen
- Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing, MI 48909, United States
| | - Kelly Jones
- Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing, MI 48909, United States
| | - Sheri Robeson
- Bureau of Laboratories, Michigan Department of Health and Human Services, Lansing, MI 48909, United States
| | - Adeline Hambley
- Ottawa County Department of Public Health, Holland, MI 49424, United States
| | - Lisa Stefanovsky
- Ottawa County Department of Public Health, Holland, MI 49424, United States
| | - Joshua Brandenburg
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
| | - Kelley Hise
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
| | - Beth Tolar
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
| | - Megin C Nichols
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
| | - Colin Basler
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA 30333, United States
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