A Strong Evidence Outbreak of Salmonella Enteritidis in Central Italy Linked to the Consumption of Contaminated Raw Sheep Milk Cheese

Salmonellosis is the second most commonly reported gastrointestinal infection in humans after campylobacteriosis, and an important cause of foodborne outbreaks in the EU/EEA. The vast majority (72.4%) of the salmonellosis foodborne outbreaks reported in EU in 2019 were caused by Salmonella Enteritidis, even if their total number due to this serovar decreased. In spring 2020, a foodborne outbreak of S. Enteritidis occurred in the Marche region (Central Italy), involving 85 people. The common exposure source was a cheese, pecorino “primo sale”, produced with raw sheep milk. The cheese batches were produced by two local dairies, with a livestock production facility, also including a sheep farm, being part of one dairy. Bacteriological analysis of samples collected allowed the detection of S. Enteritidis in animal faeces, environmental samples, raw-milk bulk tanks and milk taken from single animals. These data confirm that, despite the scarce scientific evidence, S. Enteritidis can infect sheep and be shed into the animals’ milk. Hence, this is a real risk for public health when unpasteurized milk is used in production of such cheese. The present paper describes the results of the investigations conducted to clarify this outbreak.

Design and SAR assessment of three compact 5G antenna arrays

In this paper three different multi stub antenna arrays at 27–29.5 GHz are designed. The proposed antenna arrays consist of eight single elements. The structure of feeding parts is the same but the radiation elements are different. The feeding network for array is an eight way Wilkinson power divider (WPD). To guarantee the simulation results, one of the proposed structures is fabricated and measured (namely the characteristics of S11, E-, and H-plane patterns) which shows acceptable consistency with measurement results. The simulation results by CST and HFSS show reasonable agreement for reflection coefficient and radiation patterns in the E- and H- planes. The overall size of the proposed antenna in maximum case is 29.5 mm × 52 mm × 0.38 mm (2.8 $${{\varvec{\lambda}}}_{0}$$ λ 0 × 4.86$${{\varvec{\lambda}}}_{0}$$ λ 0 × 0.036$${{\varvec{\lambda}}}_{0}$$ λ 0 ). Moreover, for Specific Absorption Rate (SAR) estimation, a three-layer spherical human head model (skin, skull, and the brain) is placed next to the arrays as the exposure source. The simulation results show that the performance of proposed antennas as low-SAR sources makes them ideal candidates for the safe usage and lack of impact of millimeter waves (mmW) on the human health. In all three cases of SAR simulations the value of SAR1g and SAR10g are below the standard limitations.

#14: Blastomycosis in 64 Wisconsin Children: Unanticipated Infection Risk and Severity in Urban Residents

Background Blastomycosis is an endemic mycosis of immunocompetent individuals, typically seen after exposure to wooded areas near rivers, lakes, and streams in rural locations, and often not considered a disease of urban environments. Disease can be isolated to lung, or disseminate to skin, bone, or central nervous system. Factors influencing disease acquisition and severity in children are unknown. Methods We analyzed acquisition risk factors and disease characteristics of blastomycosis in children treated at a tertiary care center from 1998–2018 to identify exposure source and measure disease severity, to identify cases without “typical exposure”, and to measure the effect of race on disease severity. Results Of 64 children, median age was 13.3 years, 72% were male, 38% resided in urban counties, and 50% had typical environmental exposure. Isolated pulmonary infection occurred in 33 (52%). The remaining children had evidence of dissemination including skin (N=13), bone (N=16; 7 clinically silent), and central nervous system (N=7; 3 clinically silent). Infection was moderate/severe in 19 (30%). Two children (3%) died. 79% of children with moderate/severe disease (p=0.008) and 71% of urban children (p=0.007) had no typical environmental exposure. Comparing children from urban counties to other residences, 63% versus 5% were black (p<0.001) and 71% versus 35% developed extrapulmonary dissemination (p=0.006). Moderate/severe disease occurred in 7/17 (42%) black and 12/47 (26%) children of other race (p=0.23). Conclusions Blastomycosis, endemic in urban children in the absence of typical exposure history, has frequent, sometimes clinically silent, extrapulmonary dissemination, with a trend toward more severe disease in black children.

Development of Nationwide Excess Lifetime Cancer Risk Evaluation Methods with Comprehensive Past Asbestos Exposure Reconstruction

Although exposure to asbestos via various routes has been acknowledged, comprehensive exposure and risk assessment methods have not been developed at the national level. We conducted a study to reconstruct comprehensive past asbestos exposure estimations and to suggest a method to calculate the Excess Lifetime Cancer Risk (ELCR) of Koreans. The past occupational exposure reconstruction was conducted by rebuilding the previous general population job-exposure matrix (JEM). The para-occupational and household exposure estimation was based on the pooled analysis of data from other countries as well as Korea. The neighborhood exposure from occupational sources by distance was estimated by the exponential decay model. As a result, 141 JEM exposure groups across four periods including ~79, the 80s, 90s, 2000s with a ratio of 2.0:1.0:0.5:0.05 were reconstructed. The para-occupational and household exposures were 11% and 1% of the JEM respectively. The environmental exposure source concentration from outside occupational exposure was 2.5% of the inside concentration. The ratio of the concentration of environmental exposure source (C0) to distance d (Cd) was exp−kd with a decay constant k of 6.834. The mean concentrations (f/cc) were 2.28 × 10−3 for outdoor, 4.65 × 10−5 for indoor, 1.95 × 10−2 for transportation activity, 4.44 × 10−2 for agricultural activity, and 4.68 × 10−2 for daily life activity in naturally occurring asbestos areas. Indoor and outdoor asbestos concentrations from living in a slate roof house were 1.73 × 10−6 and 2.70 × 10−8, respectively. For improved generalizability, validity, and applicability of the proposed method, further studies on each route with real assessments and experiments are required.

Media Reports as a Tool for Timely Monitoring of COVID-19–Related Deaths Among First Responders—United States, April 2020

We aimed to describe coronavirus disease 2019 (COVID-19) deaths among first responders early in the COVID-19 pandemic. We used media reports to gather timely information about COVID-19–related deaths among first responders during March 30–April 30, 2020, and evaluated the sensitivity of media scanning compared with traditional surveillance. We abstracted information about demographic characteristics, occupation, underlying conditions, and exposure source. Twelve of 19 US public health jurisdictions with data on reported deaths provided verification, and 7 jurisdictions reported whether additional deaths had occurred; we calculated the sensitivity of media scanning among these 7 jurisdictions. We identified 97 COVID-19–related first-responder deaths during the study period through media and jurisdiction reports. Participating jurisdictions reported 5 deaths not reported by the media. Sixty-six decedents worked in law enforcement, and 31 decedents worked in fire/emergency medical services. Media reports rarely noted underlying conditions. The media scan sensitivity was 88% (95% CI, 73%-96%) in the subset of 7 jurisdictions. Media reports demonstrated high sensitivity in documenting COVID-19–related deaths among first responders; however, information on risk factors was scarce. Routine collection of data on industry and occupation could improve understanding of COVID-19 morbidity and mortality among all workers.

Three Configurations of Compact Planar Multistub Microstrip Antennas for mmW Mobile Applications

Three configurations of compact planar multistub antennas are proposed in the frequency range of 27–29.5 GHz as candidates for the 5G standard frequency band. Each antenna consists of the same feeding part configuration but different structures for the dipole, director, and reflector parts. The feeding part is based on the substrate integrated waveguide (SIW) technology which results in compact size. The TE10 dominant mode is considered in the design procedure by HFSS software simulations. The proposed antennas have been simulated, fabricated, and measured (for S11, E, and H pattern). The simulation and measurement results show reasonable agreement for S11 and radiation patterns of E- and H-planes and impedance bandwidths. Moreover, for specific absorption rate (SAR) estimation, a three-layer human head model (skin, skull, and brain) is placed next to the antennas as the exposure source. The simulation results show the performance of the proposed antennas for low-SAR, which make them good candidates for safe usage concerning the negative impact of millimeter waves (mmWs) on human health. Finally, a comparison table is presented which verifies the compact size of our proposed antennas.

Diet as an Exposure Source and Mediator of Per- and Polyfluoroalkyl Substance (PFAS) Toxicity

Per- and polyfluoroalkyl substances (PFAS) are ubiquitously found in the environment due to their widespread commercial use and high chemical stability. Humans are exposed primarily through ingestion of contaminated water and food and epidemiological studies over the last several decades have shown that PFAS levels are associated with adverse chronic health effects, including cardiometabolic disorders such as hyperlipidemia and non-alcoholic fatty liver disease. Perhaps the most well-established effects, as demonstrated in animal studies and human epidemiological studies, are the metabolic alterations PFAS exposure can lead to, especially on lipid homeostasis and signaling. This altered lipid metabolism has often been linked to conditions such as dyslipidemia, leading to fatty liver disease and steatosis. Western diets enriched in high fat and high cholesterol containing foods may be an important human exposure route of PFAS and may also act as an important modulator of associated toxicities. In fact, the chemical structure of PFAS resemble fatty acids and may activate some of the same signaling cascades critical for endogenous metabolism. In this review we aim to outline known dietary exposure sources of PFAS, describe the detrimental metabolic health effects associated with PFAS exposure, and focus on studies examining emerging interaction of dietary effects with PFAS exposure that further alter the dysregulated metabolic state.