scholarly journals Mumps: an Update on Outbreaks, Vaccine Efficacy, and Genomic Diversity

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Eugene Lam ◽  
Jennifer B. Rosen ◽  
Jane R. Zucker
Keyword(s):  
Public Health ◽  
Vaccination Coverage ◽  
Disease Incidence ◽  
The United States ◽  
Mumps Virus ◽  
Control Measures ◽  
Genomic Diversity ◽  
Medical Community ◽  
Virus Infections ◽  
Mmr Vaccine

SUMMARY Mumps is an acute viral infection characterized by inflammation of the parotid and other salivary glands. Persons with mumps are infectious from 2 days before through 5 days after parotitis onset, and transmission is through respiratory droplets. Despite the success of mumps vaccination programs in the United States and parts of Europe, a recent increase in outbreaks of mumps virus infections among fully vaccinated populations has been reported. Although the effectiveness of the mumps virus component of the measles-mumps-rubella (MMR) vaccine is suboptimal, a range of contributing factors has led to these outbreaks occurring in high-vaccination-coverage settings, including the intensity of exposure, the possibility of vaccine strain mismatch, delayed implementation of control measures due to the timeliness of reporting, a lack of use of appropriate laboratory tests (such as reverse transcription-PCR), and time since last vaccination. The resurgence of mumps virus infections among previously vaccinated individuals over the past decade has prompted discussions about new strategies to mitigate the risk of future outbreaks. The decision to implement a third dose of the MMR vaccine in response to an outbreak should be considered in discussions with local public health agencies. Traditional public health measures, including the isolation of infectious persons, timely contact tracing, and effective communication and awareness education for the public and medical community, should remain key interventions for outbreak control. Maintaining high mumps vaccination coverage remains key to U.S. and global efforts to reduce disease incidence and rates of complications.

scholarly journals Tick-Borne Flaviviruses, with a Focus on Powassan Virus

2018 ◽  
Vol 32 (1) ◽  
Author(s):  
Gábor Kemenesi ◽  
Krisztián Bányai
Keyword(s):  
Disease Incidence ◽  
Russian Far East ◽  
Far East ◽  
Case Fatality ◽  
The United States ◽  
Diagnostic Methods ◽  
Control Measures ◽  
Virus Infections ◽  
Vector Population ◽  
Powassan Virus

SUMMARYThe tick-borne pathogen Powassan virus is a rare cause of encephalitis in North America and the Russian Far East. The number of documented cases described since the discovery of Powassan virus in 1958 may be <150, although detection of cases has increased over the past decade. In the United States, the incidence of Powassan virus infections expanded from the estimated 1 case per year prior to 2005 to 10 cases per year during the subsequent decade. The increased detection rate may be associated with several factors, including enhanced surveillance, the availability of improved laboratory diagnostic methods, the expansion of the vector population, and, perhaps, altered human activities that lead to more exposure. Nonetheless, it remains unclear whether Powassan virus is indeed an emerging threat or if enzootic cycles in nature remain more-or-less stable with periodic fluctuations of host and vector population sizes. Despite the low disease incidence, the approximately 10% to 15% case fatality rate of neuroinvasive Powassan virus infection and the temporary or prolonged sequelae in >50% of survivors make Powassan virus a medical concern requiring the attention of public health authorities and clinicians. The medical importance of Powassan virus justifies more research on developing specific and effective treatments and prevention and control measures.

scholarly journals Aggressive Colonization Screening and Infection Control Measures in Containment of NDM-5 Carbapenemase-Producing CRE

2020 ◽  
Vol 41 (S1) ◽  
pp. s458-s459
Author(s):  
Ishrat Kamal-Ahmed ◽  
Kate Tyner ◽  
Teresa Fitzgerald ◽  
Heather Adele Moulton-Meissner ◽  
Gillian McAllister ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Acute Care Hospital ◽  
Healthcare Facility ◽  
The United States ◽  
Control Measures ◽  
Care Hospital ◽  
Clinical Culture ◽  
Medical Histories ◽  
Asymptomatic Case

Background: In April 2019, Nebraska Public Health Laboratory identified an NDM-producing Enterobacter cloacae from a urine sample from a rehabilitation inpatient who had recently received care in a specialized unit (unit A) of an acute-care hospital (ACH-A). After additional infections occurred at ACH-A, we conducted a public health investigation to contain spread. Methods: A case was defined as isolation of NDM-producing carbapenem-resistant Enterobacteriaceae (CRE) from a patient with history of admission to ACH-A in 2019. We conducted clinical culture surveillance, and we offered colonization screening for carbapenemase-producing organisms to all patients admitted to unit A since February 2019. We assessed healthcare facility infection control practices in ACH-A and epidemiologically linked facilities by visits from the ICAP (Infection Control Assessment and Promotion) Program. The recent medical histories of case patients were reviewed. Isolates were evaluated by whole-genome sequencing (WGS). Results: Through June 2019, 7 cases were identified from 6 case patients: 4 from clinical cultures and 3 from 258 colonization screens including 1 prior unit A patient detected as an outpatient (Fig. 1). Organisms isolated were Klebsiella pneumoniae (n = 5), E. cloacae (n = 1), and Citrobacter freundii (n = 1); 1 patient had both NDM-producing K. pneumoniae and C. freundii. Also, 5 case patients had overlapping stays in unit A during February–May 2019 (Fig. 2); common exposures in unit A included rooms in close proximity, inhabiting the same room at different times and shared caregivers. One case-patient was not admitted to unit A but shared caregivers, equipment, and devices (including a colonoscope) with other case patients while admitted to other ACH-A units. No case patients reported travel outside the United States. Screening at epidemiologically linked facilities and clinical culture surveillance showed no evidence of transmission beyond ACH-A. Infection control assessments at ACH-A revealed deficiencies in hand hygiene, contact precautions adherence, and incomplete cleaning of shared equipment within and used to transport to/from a treatment room in unit A. Following implementation of recommended infection control interventions, no further cases were identified. Finally, 5 K. pneumoniae of ST-273 were related by WGS including carriage of NDM-5 and IncX3 plasmid supporting transmission of this strain. Further analysis is required to relate IncX3 plasmid carriage and potential transmission to other organisms and sequence types identified in this study. Conclusions: We identified a multiorganism outbreak of NDM-5–producing CRE in an ACH specialty care unit. Transmission was controlled through improved infection control practices and extensive colonization screening to identify asymptomatic case-patients. Multiple species with NDM-5 were identified, highlighting the potential role of genotype-based surveillance.Funding: NoneDisclosures: Muhammad Salman Ashraf reports that he is the principal investigator for a study funded by an investigator-initiated research grant.

scholarly journals 1721. An Outbreak of Botulism Associated With Nacho Cheese Sauce From a Gas Station in California

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S53-S53
Author(s):  
Hilary Rosen ◽  
Akiko Kimura ◽  
Rituparna Mukhopadhyay ◽  
June Nash ◽  
Jason Boetzer ◽  
...  
Keyword(s):  
Public Health ◽  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
The United States ◽  
Control Measures ◽  
California Department ◽  
Illness Onset ◽  
Gas Station ◽  
Foodborne Botulism

Abstract Background Foodborne botulism is rare with 0–6 cases reported annually in California. During April 24–28, 2017, 4 hospitalized patients with suspect foodborne botulism were reported to the California Department of Public Health (CDPH) from 2 adjacent California counties. In collaboration with local public and environmental health, CDPH conducted an investigation to determine the magnitude of the outbreak, identify potential sources, and implement control measures. Methods A case was defined as clinical botulism in a visitor to or resident of Sacramento County with illness onset during April 20 to May 5, 2017. Case-patients or their proxies were interviewed. Patient specimens and suspect food items were tested for the presence of botulinum toxin and toxin-producing Clostridium botulinum; C. botulinum isolates underwent whole genome sequencing (WGS) at the CDPH laboratory. Results In April–May 2017, a total of 10 patients were hospitalized with laboratory-confirmed botulism. Median age was 34 years (range 16–57); 7 were male, and 8 were Latino. All patients required intensive care, 7 required ventilator support, and 1 died. Nine patients confirmed visiting Gas Station A in the week before illness onset; 8 reported consuming nacho cheese sauce served from a dispenser there. Inspection of Gas Station A on May 5 indicated that the cheese in the dispenser had a best by date of April 11; the dispenser was removed that day, before all patients were identified. The remaining pouch of nacho cheese sauce was laboratory confirmed to have botulinum toxin type A and toxin-producing C. botulinum. C. botulinum isolates from 3 patients clustered with the cheese isolate by WGS. Conclusion Contaminated nacho cheese sauce served at a local gas station was the source of the largest outbreak of foodborne botulism reported to date in California. No other botulism cases associated with this commercial cheese sauce were identified elsewhere in the United States; although the mechanism of contamination is unclear, the cheese was likely contaminated locally. Intensive public health investigation and intervention, before all cases were identified and C. botulinum toxin was detected in the product, likely prevented additional cases and possible deaths Disclosures All authors: No reported disclosures.

scholarly journals Emerging Antimicrobial-Resistant High-Risk Klebsiella pneumoniae Clones ST307 and ST147

2020 ◽  
Vol 64 (10) ◽  
Author(s):  
Gisele Peirano ◽  
Liang Chen ◽  
Barry N. Kreiswirth ◽  
Johann D. D. Pitout
Keyword(s):  
Public Health ◽  
High Risk ◽  
Klebsiella Pneumoniae ◽  
The United States ◽  
Medical Community ◽  
Global Public Health ◽  
African Countries ◽  
Content Type ◽  
Public Health Burden ◽  
Worldwide Distribution

ABSTRACT There is an enormous global public health burden due to antimicrobial-resistant (AMR) Klebsiella pneumoniae high-risk clones. K. pneumoniae ST307 and ST147 are recent additions to the family of successful clones in the species. Both clones likely emerged in Europe during the early to mid-1990s and, in a relatively short time, became prominent global pathogens, spreading to all continents (with the exception of Antarctica). ST307 and ST147 consist of multiple clades/clusters and are associated with various carbapenemases (i.e., KPCs, NDMs, OXA-48-like, and VIMs). ST307 is endemic in Italy, Colombia, the United States (Texas), and South Africa, while ST147 is endemic in India, Italy, Greece, and certain North African countries. Both clones have been introduced into regions of nonendemicity, leading to worldwide nosocomial outbreaks. Genomic studies showed ST307 and ST147 contain identical gyrA and parC mutations and likely obtained plasmids with blaCTX-M-15 during the early to mid-2000s, which aided in their global distribution. ST307 and ST147 then acquired plasmids with various carbapenemases during the late 2000s, establishing themselves as important AMR pathogens in certain regions. Both clones are likely underreported due to restricted detection methodologies. ST307 and ST147 have the ability to become major threats to public health due to their worldwide distribution, ability to cause serious infections, and association with AMR, including panresistance. The medical community at large, especially those concerned with antimicrobial resistance, should be aware of the looming threat posed by emerging AMR high-risk clones such as K. pneumoniae ST307 and ST147.

scholarly journals Re-emerging Infectious Disease (RED) Alert tool

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Maneesha Chitanvis ◽  
Ashlynn Daughton ◽  
Forest M Altherr ◽  
Geoffery Fairchild ◽  
William Rosenberger ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Infectious Diseases ◽  
Disease Incidence ◽  
Emerging Infectious Disease ◽  
Control Measures ◽  
Public Health Response ◽  
Incidence Trends ◽  
Effective Public Health ◽  
Emergence Event

Objective: Although relying on verbal definitions of "re-emergence", descriptions that classify a “re-emergence” event as any significant recurrence of a disease that had previously been under public health control, and subjective interpretations of these events is currently the conventional practice, this has the potential to hinder effective public health responses. Defining re-emergence in this manner offers limited ability for ad hoc analysis of prevention and control measures and facilitates non-reproducible assessments of public health events of potentially high consequence. Re-emerging infectious disease alert (RED Alert) is a decision-support tool designed to address this issue by enhancing situational awareness by providing spatiotemporal context through disease incidence pattern analysis following an event that may represent a local (country-level) re-emergence. The tool’s analytics also provide users with the associated causes (socioeconomic indicators) related to the event, and guide hypothesis-generation regarding the global scenario.Introduction: Definitions of “re-emerging infectious diseases” typically encompass any disease occurrence that was a historic public health threat, declined dramatically, and has since presented itself again as a significant health problem. Examples include antimicrobial resistance leading to resurgence of tuberculosis, or measles re-appearing in previously protected communities. While the language of this verbal definition of “re-emergence” is sensitive enough to capture most epidemiologically relevant resurgences, its qualitative nature obfuscates the ability to quantitatively classify disease re-emergence events as such.Methods: Our tool automatically computes historic disease incidence and performs trend analyses to help elucidate events which a user may considered a true re-emergence in a subset of pertinent infectious diseases (measles, cholera, yellow fever, and dengue). The tool outputs data visualizations that illustrate incidence trends in diverse and informative ways. Additionally, we categorize location and incidence-specific indicators for re-emergence to provide users with associated indicators as well as justifications and documentation to guide users’ next steps. Additionally, the tool also houses interactive maps to facilitate global hypothesis-generation.Results: These outputs provide historic trend pattern analyses as well as contextualization of the user’s situation with similar locations. The tool also broadens users' understanding of the given situation by providing related indicators of the likely re-emergence, as well as the ability to investigate re-emergence factors of global relevance through spatial analysis and data visualization.Conclusions: The inability to categorically name a re-emergence event as such is due to lack of standardization and/or availability of reproducible, data-based evidence, and hinders timely and effective public health response and planning. While the tool will not explicitly call out a user scenario as categorically re-emergent or not, by providing users with context in both time and space, RED Alert aims to empower users with data and analytics in order to substantially enhance their contextual awareness; thus, better enabling them to formulate plans of action regarding re-emerging infectious disease threats at both the country and global level.

scholarly journals Can Wastewater be Used to Improve our COVID-19 Surveillance Efforts?

CommonHealth ◽  
2020 ◽  
Vol 1 (3) ◽  
pp. 141-147
Author(s):  
Shannon McGinnis ◽  
Shane Mclouglin ◽  
Tiffany Buturla ◽  
Nishita D'Souza ◽  
José Logo ◽  
...  
Keyword(s):  
Public Health ◽  
Control Strategies ◽  
Population Level ◽  
The United States ◽  
Control Measures ◽  
Clear Understanding ◽  
Health Control ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Wastewater Samples

As the spread of COVID-19 continues to significantly impact daily life in the United States and globally, there is a need for a clear understanding of disease prevalence in communities. Traditional methods that rely on counting individual cases often result in underreporting due to limited access to testing or healthcare. This issue is further exacerbated by the spread of COVID-19 by asymptomatic or presymptomatic individuals who may not seek testing. Historically, wastewater surveillance has been used to provide population-level data on the prevalence of infectious diseases in communities. Data collected through wastewater surveillance has been used to advise public health control measures, such as vaccination campaigns, and to detect local outbreaks before cases are reported to public health authorities. For this reason, researchers around the globe have been analyzing wastewater samples for SARS-CoV-2 to assist in our response to the existing COVID-19 pandemic. This commentary discusses the potential utility of wastewater-based surveillance to advise public health control strategies for COVID-19 and discusses how it may be used to strengthen local surveillance efforts in Philadelphia.

scholarly journals Meeting the Mental Health Needs of College Student-Mothers during the COVID-19 Pandemic in the United States

Women ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 137-142
Author(s):  
Kobi V. Ajayi
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Psychological Impact ◽  
The United States ◽  
Poor Mental Health ◽  
Control Measures ◽  
Remote Work ◽  
Student Mothers ◽  
Infection Control Measures ◽  
Rapid Spread

The coronavirus (COVID-19) pandemic is the deadliest public health emergency in the twenty-first century. To mitigate the rapid spread of the virus, institutions around the globe, including higher education, instituted infection control measures such as social distancing and restricted movements with virtual/remote work and learning environments. These changes, including the pandemic-related stressors, are associated with poor mental health among college students. However, student-mothers may encounter an aggravated psychological impact of the pandemic because of their competing and challenging intersecting roles. Multipronged strategies and targeted-mental health services that consider the needs of student-mothers, their children, and families are encouraged to mitigate the pandemic’s impact. Doing so has important implications for public health, policy, and research.

scholarly journals Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak—Iowa, 2015–2016

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Mona Marin ◽  
Tricia L Kitzmann ◽  
Lisa James ◽  
Patricia Quinlisk ◽  
Wade K Aldous ◽  
...  
Keyword(s):  
Public Health ◽  
Vaccine Coverage ◽  
The United States ◽  
Mmr Vaccine ◽  
Public Health Response ◽  
University Of Iowa ◽  
Outbreak Control ◽  
Response Planning ◽  
Health Response ◽  
The University

Abstract Background The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015–2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Methods Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs. Results Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administered and 1920 miles traveled. The total cost was &gt;$649 000, roughly equally distributed between standard outbreak control activities and third-dose MMR vaccination (55% and 45%, respectively). Conclusions Public health response to the mumps outbreak at the University of Iowa required important amounts of personnel time and other resources. Associated costs were sizable enough to affect other public health activities.

scholarly journals Mumps: MMR vaccination and genetic diversity of mumps virus, 2007–2011 in Catalonia, Spain

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Irene Barrabeig ◽  
◽  
Andrés Antón ◽  
Núria Torner ◽  
Tomàs Pumarola ◽  
...  
Keyword(s):  
Public Health ◽  
Amino Acid ◽  
Phylogenetic Analyses ◽  
Screening Method ◽  
Mumps Virus ◽  
Public Health Care ◽  
Categorical Variables ◽  
Health Staff ◽  
Mmr Vaccine ◽  
Virus Diversity

Abstract Background Mumps is a vaccine-preventable disease but outbreaks have been reported in persons vaccinated with two doses of MMR vaccine. The objective was to describe the demographic features, vaccination effectiveness and genetic mumps virus diversity among laboratory-confirmed cases between 2007 and 2011 in Catalonia. Methods Cases and outbreaks of mumps notified to the notifiable diseases system of Catalonia between 2007 and 2011 retrospectively registered were included. Public health care centres provided written immunization records to regional public health staff to determine the vaccination history. Saliva and serum specimens were collected from suspected cases for laboratory-confirmation using real-time reverse-transcriptase PCR (rtRT-PCR) or serological testing. Phylogenetic analysis of the complete SH gene (316 nucleotides) and complete coding HN protein (1749 nucleotides) sequences was made. Categorical variables were compared using the Chi-square or Fisher’s tests and continuous variables using the Student test. Vaccination effectiveness by number of MMR doses was estimated using the screening method. Results During the study period, 581 confirmed cases of mumps were notified (incidence rate 1.6 cases/100,000 persons-year), of which 60% were male. Three hundred sixty-four laboratory-confirmed cases were reported, of which 44% were confirmed by rtRT-PCR. Of the 289 laboratory-confirmed cases belonging to vaccination cohorts, 33.5% (97) had received one dose of MMR vaccine and 50% (145) two doses. Based on phylogenetic analyses of 316-nucleotide and 174-nucleotide SH sequences, the viruses belonging to viral genotypes were: genotype G (126), genotype D (23), genotype H (2), genotype F (2), genotype J (1), while one remained uncharacterized. Amino acid differences were detected between circulating strains and the Jeryl Lynn vaccine strains, although the majority of amino acid substitutions were genotype-specific. Fifty-one outbreaks were notified that included 324 confirmed mumps cases. Genotype G was the most frequent genotype detected. The family (35%), secondary schools (25%) and community outbreaks (18%) were the most frequent settings. Conclusions Our study shows that genotype G viruses are the most prevalent in Catalonia. Most cases occurred in people who had received two doses of MMR, suggesting inadequate effectiveness of the Jeryl Lynn vaccine strain. The possible factors related are discussed.

Sign in / Sign up

Export Citation Format

Share Document