Effects of salvage logging on fire risks after bark beetle outbreaks in Colorado lodgepole pine forests

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Bryon J. Collins; Chuck C. Rhoades; Michael A. Battaglia; Robert M. Hubbard

2012-01-01

Most mature lodgepole pine (Pinus contorta var. latifolia Engelm. ex Wats.) forests in the central and southern Rocky Mountains originated after stand-replacing wildfires or logging (Brown 1975, Lotan and Perry 1983, Romme 1982). In recent years, mountain pine beetle (Dendroctonus ponderosae Hopkins) outbreaks have created a widespread, synchronous disturbance (i.e.,...

Densities of breeding birds and changes in vegetation in an alaskan boreal forest following a massive disturbance by spruce beetles

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Matsuoka, S.M.; Handel, C.M.; Ruthrauff, D.R.

2001-01-01

We examined bird and plant communities among forest stands with different levels of spruce mortality following a large outbreak of spruce beetles (Dendroctonus rufipennis (Kirby)) in the Copper River Basin, Alaska. Spruce beetles avoided stands with black spruce (Picea mariana) and selectively killed larger diameter white spruce (Picea glauca), thereby altering forest structure and increasing the dominance of black spruce in the region. Alders (Alnus sp.) and crowberry (Empetrum nigrum) were more abundant in areas with heavy spruce mortality, possibly a response to the death of overstory spruce. Grasses and herbaceous plants did not proliferate as has been recorded following outbreaks in more coastal Alaskan forests. Two species closely tied to coniferous habitats, the tree-nesting Ruby-crowned Kinglet (Regulus calendula) and the red squirrel (Tamiasciurus hudsonicus), a major nest predator, were less abundant in forest stands with high spruce mortality than in low-mortality stands. Understory-nesting birds as a group were more abundant in forest stands with high levels of spruce mortality, although the response of individual bird species to tree mortality was variable. Birds breeding in stands with high spruce mortality likely benefited reproductively from lower squirrel densities and a greater abundance of shrubs to conceal nests from predators.

Severity of a mountain pine beetle outbreak across a range of stand conditions in Fraser Experimental Forest, Colorado, United States

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Anthony G. Vorster; Paul H. Evangelista; Thomas J. Stohlgren; Sunil Kumar; Charles C. Rhoades; Robert M. Hubbard; Antony S. Cheng; Kelly Elder

2017-01-01

The recent mountain pine beetle (Dendroctonus ponderosae Hopkins) outbreaks had unprecedented effects on lodgepole pine (Pinus contorta var. latifolia) in western North America. We used data from 165 forest inventory plots to analyze stand conditions that regulate lodgepole pine mortality across a wide range of stand structure and species composition at the Fraser...

A Review of Dendroctonus frontalis Zimmermann Systematics

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Anthony I. Cognato

2011-01-01

The systematic history of the southern pine beetle, Dendroctonus frontalis Zimmermann, is reviewed. Morphological, biological, karyological, and molecular data clearly define and diagnose the species limits of D. frontalis. More complete phylogenetic analysis and characterization of population genetic variation will further clarify the evolutionary history of the D....

Determining the vulnerability of Mexican pine forests to bark beetles of the genus Dendroctonus Erichson (Coleoptera: Curculionidae: Scolytinae)

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Y. Salinas-Moreno; A. Ager; C.F. Vargas; J.L. Hayes; G. Zuniga

2010-01-01

Bark beetles of the genus Dendroctonus are natural inhabitants of forests; under particular conditions some species of this genus can cause large-scale tree mortality. However, only in recent decades has priority been given to the comprehensive study of these insects in Mexico. Mexico possesses high ecological diversity in Dendroctonus-...

Attraction of the southern pine beetle, Dendroctonus frontalis, to pheromone components of the western pine beetle, Dendroctonus brevicomis (Coleoptera: Curculionidae: Scolytinae), in an allopatric zone

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Deepa S. Pureswaran; Richard W. Hofstetter; Brian T. Sullivan

2008-01-01

Subtle differences in pheromone components of sympatric species should be attractive only to the producing species and unattractive or repellent to the nonproducing species, and thereby maintain reproductive isolation and reduce competition between species. Bark beetles Dendroctonus brevicomis and D. frontalis (Coleoptera: Curculionidae) are known to...

Separating Trends in Whitebark Pine Radial Growth Related to Climate and Mountain Pine Beetle Outbreaks in the Northern Rocky Mountains, USA

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Saskia L. van de Gevel

2017-06-01

Full Text Available Drought and mountain pine beetle (Dendroctonus ponderosae Hopkins outbreaks have affected millions of hectares of high-elevation conifer forests in the Northern Rocky Mountains during the past century. Little research has examined the distinction between mountain pine beetle outbreaks and climatic influence on radial growth in endangered whitebark pine (Pinus albicaulis Engelm. ecosystems. We used a new method to explore divergent periods in whitebark pine radial growth after mountain pine beetle outbreaks across six sites in western Montana. We examined a 100-year history of mountain pine beetle outbreaks and climate relationships in whitebark pine radial growth to distinguish whether monthly climate variables or mountain pine outbreaks were the dominant influence on whitebark pine growth during the 20th century. High mortality of whitebark pines was caused by the overlapping effects of previous and current mountain pine beetle outbreaks and white pine blister rust infection. Wet conditions from precipitation and snowpack melt in the previous summer, current spring, and current summer benefit whitebark pine radial growth during the following growing season. Whitebark pine radial growth and climate relationships were strongest in sites less affected by the mountain pine beetle outbreaks or anthropogenic disturbances. Whitebark pine population resiliency should continue to be monitored as more common periods of drought will make whitebark pines more susceptible to mountain pine beetle attack and to white pine blister rust infection.

Response of Dendroctonus mexicanus (Hopkins) to two optical isomers of verbenone

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Vicente Diaz-Nunez; Guillermo Sanchez-Martinez; Nancy E. Gillette

2006-01-01

Given the need for diminishing the use of pesticides in natural environments, in this research we investigated the efficacy of two optical isomers of verbenone (4, 6, 6-trimethylbicyclo[3.1.1] hepto-3-en-e-1) as controls of the attack of Dendroctonus mexicanus (Hopkins) (Coleoptera: Curculionidae: Scolytinae).Two experiments were established in the...

Phylogeographic analysis of the Douglas-fir beetle Dendroctonus pseudotsugae Hopkins (Coleoptera: Curculionidae: Scolytinae)

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Enrico A. Ruíz; Jane L. Hayes; John E. Rinehart; G. Zúñiga

2007-01-01

Population genetic structure studies made in genus Dendroctonus have been conducted from the perspectives of allopatric and sympatric models. In the first case, host effect and historical contingency were not recognized as a source of variation, while the later considered the host itself as a source of reproductive isolation. Nevertheless, both...

Effects of bark beetle attack on canopy fuel flammability and crown fire potential in lodgepole pine and Engelmann spruce forests

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Wesley G. Page; Martin E. Alexander; Michael J. Jenkins

2015-01-01

Large wildland fires in conifer forests typically involve some degree of crowning, with their initiation and propagation dependent upon several characteristics of the canopy fuels. Recent outbreaks of mountain pine beetle (Dendroctonus ponderosae Hopkins) in lodgepole pine (Pinus contorta Dougl. var. latifolia E ngelm.) forests and spruce beetle (Dendroctonus...

Ecological consequences of mountain pine beetle outbreaks for wildlife in western North American forests

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Saab, Victoria A.; Latif, Quresh S.; Rowland, Mary M.; Johnson, Tracey N.; Chalfoun, Anna D.; Buskirk, Steven W.; Heyward, Joslin E.; Dresser, Matthew A.

2014-01-01

Mountain pine beetle (Dendroctonus ponderosae) (MPB) outbreaks are increasingly prevalent in western North America, causing considerable ecological change in pine (Pinus spp.) forests with important implications for wildlife. We reviewed studies examining wildlife responses to MPB outbreaks and postoutbreak salvage logging to inform forest management and guide future research. Our review included 16 studies describing MPB outbreak relationships with 89 bird species and 6 studies describing relationships with 11 mammalian species, but no studies of reptiles or amphibians. We included studies that compared wildlife response metrics temporally (before versus after the outbreak) and spatially (across sites that varied in severity of outbreak) in relation to beetle outbreaks. Outbreaks ranged in size from 20,600 to ≥107 ha and studies occurred 1‐30 years after the peak MPB outbreak, but most studies were conducted over the short-term (i.e., ≤6 years after the peak of MPB-induced tree mortality). Birds were the only taxa studied frequently; however, high variability existed among those studies to allow many inferences, although some patterns were evident. Avian studies concluded that cavity-nesting species responded more favorably to beetle-killed forests than species with open-cup nests, and species nesting in the shrub layer favored outbreak forests compared with ground and open-cup canopy nesters that generally showed mixed relationships. Bark-drilling species as a group clearly demonstrated a positive short-term association with MPB epidemics compared with that of other foraging assemblages. Cavity-nesting birds that do not consume bark beetles (i.e., secondary cavity-nesting species and nonbark-drilling woodpeckers) also exhibited some positive responses to MPB outbreaks, although not as pronounced or consistent as those of bark-drilling woodpeckers. Mammalian responses to MPB outbreaks were mixed. Studies consistently reported negative effects of MPB

Biochemical evidence that Dendroctonus frontalis consists of two sibling species in Belize and Chiapas, Mexico

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Brian T. Sullivan; Alicia Nino; Benjamin Moreno; Cavell Brownie; Jorge Macias-Samano; Stephen R. Clarke; Lawrence R. Kirkendall; Gerardo. and Zuniga

2012-01-01

Dendroctonus frontalis Zimmermann (Coleoptera: Curculionidae: Scolytinae) is a major economic pest of pines in the United States, Mexico, and Central America. We report biochemical investigations relevant to the taxonomic status and semiochemistry of two distinct morphotypes of D. frontalis recently detected in the Central American...

Impact of mountain pine beetle outbreaks on forest albedo and radiative forcing, as derived from Moderate Resolution Imaging Spectroradiometer, Rocky Mountains, USA

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Vanderhoof, M.; Williams, C. A.; Ghimire, B.; Rogan, J.

2013-12-01

pine beetle (Dendroctonus ponderosae) outbreaks in North America are widespread and have potentially large-scale impacts on albedo and associated radiative forcing. Mountain pine beetle outbreaks in Colorado and southern Wyoming have resulted in persistent and significant increases in both winter albedo (change peaked 10 years post outbreak at 0.06 ± 0.01 and 0.05 ± 0.01, in lodgepole pine (Pinus contorta) and ponderosa pine (Pinus ponderosa) stands, respectively) and spring albedo (change peaked 10 years post outbreak at 0.06 ± 0.01 and 0.04 ± 0.01, in lodgepole pine and ponderosa pine stands, respectively). Instantaneous top-of-atmosphere radiative forcing peaked for both lodgepole pine and ponderosa pine stands in winter at 10 years post outbreak at -1.7 ± 0.2 W m-2 and -1.4 ± 0.2 W m-2, respectively. The persistent increase in albedo with time since mountain pine beetle disturbance combined with the continued progression of the attack across the landscape from 1994-2011 resulted in an exponential increase in winter and annual radiative cooling (MW) over time. In 2011 the rate of radiative forcing within the study area reached -982.7 ± 139.0 MW, -269.8 ± 38.2 MW, -31.1 ± 4.4 MW, and -147.8 ± 20.9 MW in winter, spring, summer, and fall, respectively. An increase in radiative cooling has the potential to decrease sensible and/or latent heat flux by reducing available energy. Such changes could affect current mountain pine beetle outbreaks which are influenced by climatic conditions.

Red Turpentine Beetle, Dendroctonus valens LeConte (Coleoptera: Scolytidae), Response to Host Semiochemicals in China

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Jianghua Sun; Zhengwan Miao; Zhen Zhang; Zhongning Zhan; Nancy Gillette

2004-01-01

The response of the introduced red turpentine beetle, Dendroctonus valens LeConte, to host semiochemicals in Shanxi Province, China, was distinctly different from that reported in previous studies conducted in the western part of the native range of D. valens in the central Sierra Nevada, CA. This Þnding suggests either that...

Insect outbreak shifts the direction of selection from fast to slow growth rates in the long-lived conifer Pinus ponderosa.

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de la Mata, Raul; Hood, Sharon; Sala, Anna

2017-07-11

Long generation times limit species' rapid evolution to changing environments. Trees provide critical global ecosystem services, but are under increasing risk of mortality because of climate change-mediated disturbances, such as insect outbreaks. The extent to which disturbance changes the dynamics and strength of selection is unknown, but has important implications on the evolutionary potential of tree populations. Using a 40-y-old Pinus ponderosa genetic experiment, we provide rare evidence of context-dependent fluctuating selection on growth rates over time in a long-lived species. Fast growth was selected at juvenile stages, whereas slow growth was selected at mature stages under strong herbivory caused by a mountain pine beetle ( Dendroctonus ponderosae ) outbreak. Such opposing forces led to no net evolutionary response over time, thus providing a mechanism for the maintenance of genetic diversity on growth rates. Greater survival to mountain pine beetle attack in slow-growing families reflected, in part, a host-based life-history trade-off. Contrary to expectations, genetic effects on tree survival were greatest at the peak of the outbreak and pointed to complex defense responses. Our results suggest that selection forces in tree populations may be more relevant than previously thought, and have implications for tree population responses to future environments and for tree breeding programs.

Antennal Transcriptome Analysis of Odorant Reception Genes in the Red Turpentine Beetle (RTB, Dendroctonus valens.

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Xiao-Cui Gu

Full Text Available The red turpentine beetle (RTB, Dendroctonus valens LeConte (Coleoptera: Curculionidae, Scolytinae, is a destructive invasive pest of conifers which has become the second most important forest pest nationwide in China. Dendroctonus valens is known to use host odors and aggregation pheromones, as well as non-host volatiles, in host location and mass-attack modulation, and thus antennal olfaction is of the utmost importance for the beetles' survival and fitness. However, information on the genes underlying olfaction has been lacking in D. valens. Here, we report the antennal transcriptome of D. valens from next-generation sequencing, with the goal of identifying the olfaction gene repertoire that is involved in D. valens odor-processing.We obtained 51 million reads that were assembled into 61,889 genes, including 39,831 contigs and 22,058 unigenes. In total, we identified 68 novel putative odorant reception genes, including 21 transcripts encoding for putative odorant binding proteins (OBP, six chemosensory proteins (CSP, four sensory neuron membrane proteins (SNMP, 22 odorant receptors (OR, four gustatory receptors (GR, three ionotropic receptors (IR, and eight ionotropic glutamate receptors. We also identified 155 odorant/xenobiotic degradation enzymes from the antennal transcriptome, putatively identified to be involved in olfaction processes including cytochrome P450s, glutathione-S-transferases, and aldehyde dehydrogenase. Predicted protein sequences were compared with counterparts in Tribolium castaneum, Megacyllene caryae, Ips typographus, Dendroctonus ponderosae, and Agrilus planipennis.The antennal transcriptome described here represents the first study of the repertoire of odor processing genes in D. valens. The genes reported here provide a significant addition to the pool of identified olfactory genes in Coleoptera, which might represent novel targets for insect management. The results from our study also will assist with evolutionary

A new species of bark beetle, Dendroctonus mesoamericanus sp nov. (Curculionidae: Scolytinae), in southern Mexico and Central America

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Francisco Armendariz-Toledano; Alicia Nino; Brian T. Sullivan; Lawrence R. Kirkendall; Gerado Zunig

2015-01-01

The bark beetle Dendroctonus mesoamericanus sp. nov. is described from a population in Parque Nacional Lagunas de Montebello, La Trinitaria, Chiapas, Mexico. This species belongs to the D. frontalis complex, which includes D. adjunctus Blandford 1897, D. approximatus Dietz 1890, D....

Nitrogen cycling following mountain pine beetle disturbance in lodgepole pine forests of Greater Yellowstone

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Jacob M. Griffin; Monica G. Turner; Martin Simard

2011-01-01

Widespread bark beetle outbreaks are currently affecting multiple conifer forest types throughout western North America, yet many ecosystem-level consequences of this disturbance are poorly understood. We quantified the effect of mountain pine beetle (Dendroctonus ponderosae) outbreak on nitrogen (N) cycling through litter, soil, and vegetation in...

Mountain pine beetle in lodgepole pine: mortality and fire implications (Project INT-F-07-03)

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Jennifer G. Klutsch; Daniel R. West; Mike A Battaglia; Sheryl L. Costello; José F. Negrón; Charles C. Rhoades; John Popp; Rick Caissie

2013-01-01

Mountain pine beetle (Dendroctonus ponderosae Hopkins) has infested over 2 million acres of lodgepole pine (Pinus contorta Dougl. ex Loud.) forest since an outbreak began approximately in 2000 in north central Colorado. The tree mortality from mountain pine beetle outbreaks has the potential to alter stand composition and stand...

Pheromone-mediated mate location and discrimination by two syntopic sibling species of Dendroctonus bark beetles in Chiapas, Mexico

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Alicia Nino-Dominguez; Brian T. Sullivan; Jose H. Lopez-Urbina; Jorge E. Macias-Samano

2015-01-01

Where their geographic and host ranges overlap, sibling species of tree-killing bark beetles may simultaneously attack and reproduce on the same hosts. However, sustainability of these potentially mutually beneficial associations demands effective prezygotic reproductive isolation mechanisms between the interacting species. The pine bark beetle, Dendroctonus...

Radiolabelling of Chrysomya megacephala (Fabricius, 1794) (Diptera, Calliphoridae) and rearing of Belonuchus rufipennis (Fabricius, 1801) (Coleoptera, Staphylinidae) on eggs of this fly

International Nuclear Information System (INIS)

Garcia, C.R.

1993-01-01

The possibility of the radiolabelling method for Chrysomya megacephala (Fabricius, 1794) (Diptera, Calliphoridae) was studied. Five males from 0 to 16 hours of age proceeding from artificial rearing, were labelled through its diet. The radioisotope used was Phosphorus-32, in the chemical form of sodium phosphate (Na 2 H 32 P O 4 ), mixed into a sucrose solution of 10% sugar. After 25 hours of labelling and feeding period, each male was placed into a cage together with 20 females of the same age, for mating. The radioactivity of each male and of the genitalia of each female was verified through liquid scintillation counting. It was observed that the males showed high activity levels, above 1,7 x 10 6 counts per minute at an average of 3,1 x 10 6 cpm. Much smaller and more variable was the activity showed by the genitalia of the females: between 123 and 35.323 cpm, at an average of 2.986 cpm. As a conclusion it could be observed that the methodology of tagging this species of flies with radioactive phosphorus is perfectly suitable for ecological and behavioural studies. During the experiments of radiolabelling it could be observed that the predator Belonuchus rufipennis (Fabr., 1801) (Col., Staphylinidae) caused severe attack to recently laid eggs of the flies. To verify the possibility of rearing this insect in the laboratory, adults of the predator were maintained into Petri dishes containing eggs and water. Eggs of the predator, newly hatched larvae, pupae and adults were transferred separately into other Petri dishes for daily observations. As results it could be observed that the egg phase of the predator was two days. The development of the larvae is 10,7 days, and 5,9 days of the pupae. As a remark it could be observed that the eggs of the flies were well accepted by the predator even if dead, after maintenance into a freezer. As a final conclusion it could be confirmed that rearing of Belonuchus rufipennis is perfectly feasible under laboratory conditions

Applied chemical ecology of the mountain pine beetle

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Robert A. Progar; Nancy Gillette; Christopher J. Fettig; Kathryn Hrinkevich

2014-01-01

Mountain pine beetle, Dendroctonus ponderosae Hopkins, is a primary agent of forest disturbance in western North America. Episodic outbreaks occur at the convergence of favorable forest age and size class structure and climate patterns. Recent outbreaks have exceeded the historic range of variability of D. ponderosae-caused tree mortality affecting ecosystem goods and...

Flight periodicity of the Douglas-fir beetle, Dendroctonus pseudotsugae Hopkins (Coleoptera: Curculionidae: Scolytinae) in Colorado, U.S.A

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Jose F. Negron; Willis C. Schaupp; Lee Pederson

2011-01-01

There are about 500 species of bark beetles (Coleoptera: Curculionidae: Scolytinae) in the United States (Wood 1982). A number of them are important disturbance agents in forested ecosystems, occasionally creating large tracts of dead trees. One eruptive species is the Douglas-fir beetle, Dendroctonus pseudotsugae Hopkins, which utilizes Douglas-fir, Pseudotsuga...

Is lodgepole pine mortality due to mountain pine beetle linked to the North American Monsoon?

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Sara A. Goeking; Greg C. Liknes

2012-01-01

Regional precipitation patterns may have influenced the spatial variability of tree mortality during the recent mountain pine beetle (Dendroctonus ponderosa) (MPB) outbreak in the western United States. Data from the Forest Inventory and Analysis (FIA) Program show that the outbreak was especially severe in the state of Colorado where over 10 million lodgepole pines (...

Isolation and characterization of 16 microsatellite loci in the mountain pine beetle, Dendroctonus ponderosae Hopkins (Coleoptera: Curculionidae: Scolytinae)

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C. S. Davis; K. E. Mock; B. J. Bentz; S. M. Bromilow; N. V. Bartell; B. W. Murray; A. D. Roe; J. E. K. Cooke

2009-01-01

We isolated 16 polymorphic microsatellite loci in the mountain pine beetle (Dendroctonus ponderosae Hopkins) and developed conditions for amplifying these markers in four multiplex reactions. Three to 14 alleles were detected per locus across two sampled populations. Observed and expected heterozygosities ranged from 0.000 to 0.902 and from 0.100 to 0.830, respectively...

A Comment on “Management for Mountain Pine Beetle Outbreak Suppression: Does Relevant Science Support Current Policy?”

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Christopher J. Fettig

2014-04-01

Full Text Available There are two general approaches for reducing the negative impacts of mountain pine beetle, Dendroctonus ponderosae Hopkins, on forests. Direct control involves short-term tactics designed to address current infestations by manipulating mountain pine beetle populations, and includes the use of fire, insecticides, semiochemicals, sanitation harvests, or a combination of these treatments. Indirect control is preventive, and designed to reduce the probability and severity of future infestations within treated areas by manipulating stand, forest and/or landscape conditions by reducing the number of susceptible host trees through thinning, prescribed burning, and/or alterations of age classes and species composition. We emphasize that “outbreak suppression” is not the intent or objective of management strategies implemented for mountain pine beetle in the western United States, and that the use of clear, descriptive language is important when assessing the merits of various treatment strategies.

Trapping Douglas-fir beetle (Dendroctonus pseudotsugae) with pheromone baited multiple-funnel traps does not reduce Douglas-fir (Pseudotsuga menziesii) mortality

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R.A. Progar; N. Sturdevant; M.J. Rinella

2010-01-01

Douglas-fir beetle (Dendroctonus pseudotsugae Hopkins) (DFB) causes considerable mortality to Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) in western North American forests. We evaluated the use of semiochemical-baited multiple-funnel traps for the protection of small, high-value stands of trees, such as those occurring...

A dynamical model for bark beetle outbreaks

Czech Academy of Sciences Publication Activity Database

Křivan, Vlastimil; Lewis, M.; Bentz, B. J.; Bewick, S.; Lenhart, S. M.; Liebhold, A.

2016-01-01

Roč. 407, OCT 21 (2016), s. 25-37 ISSN 0022-5193 Institutional support: RVO:60077344 Keywords : bistability * bark beetle * Dendroctonus ponderosae Subject RIV: EH - Ecology, Behaviour Impact factor: 2.113, year: 2016 http://www.sciencedirect.com/science/article/pii/S0022519316301928

The Current Status of the Distribution Range of the Western Pine Beetle, Dendroctonus brevicomis (Curculionidae: Solytinae) in Northern Mexico.

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Valerio-Mendoza, O; Armendáriz-Toledano, F; Cuéllar-Rodríguez, G; Negrón, José F; Zúñiga, G

2017-09-01

The distribution range of the western pine beetle Dendroctonus brevicomis LeConte (Coleoptera: Curculionidae) is supported only by scattered records in the northern parts of Mexico, suggesting that its populations may be marginal and rare in this region. In this study, we review the geographical distribution of D. brevicomis in northern Mexico and perform a geometric morphometric analysis of seminal rod shape to evaluate its reliability for identifying this species with respect to other members of the Dendroctonus frontalis Zimmermann (Coleoptera: Curculionidae) complex. Our results provide 30 new records, with 26 distributed in the Sierra Madre Occidental and 4 in the Sierra Madre Oriental. These records extend the known distribution range of D. brevicomis to Durango and Tamaulipas states in northern Mexico. Furthermore, we find high geographic variation in size and shape of the seminal rod, with conspicous differences among individuals from different geographical regions, namely west and east of the Great Basin and between mountain systems in Mexico. © The Author 2017. Published by Oxford University Press on behalf of Entomological Society of America.

Contrasting geographic patterns of genetic differentiation in body size and development time with reproductive isolation in Dendroctonus ponderosae (Coleoptera: Curculionidae, Scolytinae)

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Ryan R. Bracewell; Michael E. Pfrender; Karen E. Mock; Barbara J. Bentz

2013-01-01

Body size and development time are two critical phenotypic traits that can be highly adaptive in insects. Recent population genetic analyses and crossing experiments with the mountain pine beetle (Dendroctonus ponderosae Hopkins) have described substantial levels of neutral molecular genetic differentiation, genetic differences in phenotypic traits, and reproductive...

A Synopsis of the Taxonomic Revisions in the Genus Ceratocystis Including a Review of Blue-Staining Species Associated with Dendroctonus Bark Beetles

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Thelma J. Perry

1991-01-01

Taxonomic revisions in both the teleomorphic (sexual) and anamorphic (asexual) forms of the genus Ceratocystis Ellis & Halstead are chronicled in this review. Recognized species associated with Dendroctonus Erichson bark beetles are summarized, and several species that have been published as recombinations, species that were...

The response of Dendroctonus valens (Coleoptera: Scolytidae) and Temnochila chlorodia (Coleoptera: Trogossitidae) to Ips paraconfusus (Coleoptera: Scolytidae) pheromone components and verbenone

Science.gov (United States)

Christopher J. Fettig; Stepehen R. McKelvey; Christopher P. Dabney; Robert R. Borys

2007-01-01

The red turpentine beetle, Dendroctonus valens LeConte, 1860 (Coleoptera: Curculionidae, Scolytinae), is a common bark beetle species found throughout much of North America and China. In 2004, we observed that California fivespined ips, Ips paraconfusus Lanier, 1970 (Coleoptera: Curculionidae, Scolytinae), attack densities in logging debris were inversely related to D...

Mountain Pine Beetle Fecundity and Offspring Size Differ Among Lodgepole Pine and Whitebark Pine Hosts

OpenAIRE

Gross, Donovan

2008-01-01

Whitebark pine (Pinus albicaulis Engelmann) is a treeline species in the central Rocky Mountains. Its occupation of high elevations previously protected whitebark pine from long-term mountain pine beetle outbreaks. The mountain pine beetle, however, is currently reaching outbreaks of record magnitude in high-elevation whitebark pine. We used a factorial laboratory experiment to compare mountain pine beetle (Dendroctonus ponderosae Hopkins) life history characteristics between a typical host, ...

Efficacy of “Verbenone Plus” for protecting ponderosa pine trees and stands from Dendroctonus brevicomis (Coleoptera: Curculionidae) attack in British Columbia and California

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Christopher J. Fettig; Stephen R. McKelvey; Christopher P. Dabney; Dezene P.W. Huber; Cameron C. Lait; Donald L Fowler; John H. Borden

2012-01-01

The western pine beetle, Dendroctonus brevicomis LeConte (Coleoptera: Curculionidae, Scolytinae), is a major cause of ponderosa pine, Pinus ponderosa Douglas ex Lawson, mortality in much of western North America. We review several years of research that led to the identification of Verbenone Plus, a novel four-component...

Prescribed burning and mastication effects on surface fuels in southern pine beetle-killed loblolly pine plantations

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Aaron D. Stottlemyer; Thomas A. Waldrop; G. Geoff Wang

2015-01-01

Surface fuels were characterized in loblolly pine (Pinus taeda L.) plantations severely impacted by southern pine beetle (Dendroctonus frontalis Ehrh.) (SPB) outbreaks in the upper South Carolina Piedmont. Prescribed burning and mastication were then tested as fuel reduction treatments in these areas. Prescribed burning reduced...

Changes to the N cycle following bark beetle outbreaks in two contrasting conifer forest types.

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Griffin, Jacob M; Turner, Monica G

2012-10-01

Outbreaks of Dendroctonus beetles are causing extensive mortality in conifer forests throughout North America. However, nitrogen (N) cycling impacts among forest types are not well known. We quantified beetle-induced changes in forest structure, soil temperature, and N cycling in Douglas-fir (Pseudotsuga menziesii) forests of Greater Yellowstone (WY, USA), and compared them to published lodgepole pine (Pinus contorta var. latifolia) data. Five undisturbed stands were compared to five beetle-killed stands (4-5 years post-outbreak). We hypothesized greater N cycling responses in Douglas-fir due to higher overall N stocks. Undisturbed Douglas-fir stands had greater litter N pools, soil N, and net N mineralization than lodgepole pine. Several responses to disturbance were similar between forest types, including a pulse of N-enriched litter, doubling of soil N availability, 30-50 % increase in understory cover, and 20 % increase in foliar N concentration of unattacked trees. However, the response of some ecosystem properties notably varied by host forest type. Soil temperature was unaffected in Douglas-fir, but lowered in lodgepole pine. Fresh foliar %N was uncorrelated with net N mineralization in Douglas-fir, but positively correlated in lodgepole pine. Though soil ammonium and nitrate, net N mineralization, and net nitrification all doubled, they remained low in both forest types (mineralization; litter and soil N cycling similarly in each forest type, despite substantial differences in pre-disturbance biogeochemistry. In contrast, soil temperature and soil N-foliar N linkages differed between host forest types. This result suggests that disturbance type may be a better predictor of litter and soil N responses than forest type due to similar disturbance mechanisms and disturbance legacies across both host-beetle systems.

Verbenone interrupts attraction to host volatiles and reduces attack on Pinus tabuliformis (Pinaceae) by Dendroctonus valens (Coleoptera: Scolytidae) in the People's Republic of China

Science.gov (United States)

Jianghua Sun; Nancy Gillette; Zhengwan Miao; Zhongning Zhang Le Kang; Donald R. Owen; John D Stein

2003-01-01

The introduced red turpentine beetle, Dendroctonus valens LeConte, is one of the most economically important forest pests in the People's Republic of China, having killed more than 6 million pines in recent years. There is an urgent need to develop effective behavioral chemicals to monitor and control D. valens in the People...

Fitting outbreak models to data from many small norovirus outbreaks

Directory of Open Access Journals (Sweden)

Eamon B. O’Dea

2014-03-01

Full Text Available Infectious disease often occurs in small, independent outbreaks in populations with varying characteristics. Each outbreak by itself may provide too little information for accurate estimation of epidemic model parameters. Here we show that using standard stochastic epidemic models for each outbreak and allowing parameters to vary between outbreaks according to a linear predictor leads to a generalized linear model that accurately estimates parameters from many small and diverse outbreaks. By estimating initial growth rates in addition to transmission rates, we are able to characterize variation in numbers of initially susceptible individuals or contact patterns between outbreaks. With simulation, we find that the estimates are fairly robust to the data being collected at discrete intervals and imputation of about half of all infectious periods. We apply the method by fitting data from 75 norovirus outbreaks in health-care settings. Our baseline regression estimates are 0.0037 transmissions per infective-susceptible day, an initial growth rate of 0.27 transmissions per infective day, and a symptomatic period of 3.35 days. Outbreaks in long-term-care facilities had significantly higher transmission and initial growth rates than outbreaks in hospitals.

Using a GIS-based spot growth model and visual simulator to evaluate the effects of silvicultural treatments on southern pine beetle-infested stands

Science.gov (United States)

Chiao-Ying Chou; Roy L. Hedden; Bo Song; Thomas M. Williams

2013-01-01

Many models are available for simulating the probability of southern pine beetle (Dendroctonus frontalis Zimmermann) (SPB) infestation and outbreak dynamics. However, only a few models focused on the potential spatial SPB growth. Although the integrated pest management systems are currently adopted, SPB management is still challenging because of...

Tree response and mountain pine beetle attack preference, reproduction, and emergence timing in mixed whitebark and lodgepole pines

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Barbara J. Bentz; Celia Boone; Kenneth F. Raffa

2015-01-01

Mountain pine beetle (Dendroctonus ponderosae) is an important disturbance agent in Pinus ecosystems of western North America, historically causing significant tree mortality. Most recorded outbreaks have occurred in mid elevation lodgepole pine (Pinus contorta). In warm years, tree mortality also occurs at higher elevations in mixed species stands.

Tree regeneration and future stand development after bark beetle infestation and harvesting in Colorado lodgepole pine stands

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Byron J. Collins; Charles C. Rhoades; Robert M. Hubbard; Michael A. Battaglia

2011-01-01

In the southern Rocky Mountains, current mountain pine beetle (Dendroctonus ponderosae Hopkins) outbreaks and associated harvesting have set millions of hectares of lodgepole pine (Pinus contorta var. latifolia Engelm. ex Wats.) forest onto new stand development trajectories. Information about immediate, post-disturbance tree regeneration will provide insight on...

Strategies, tools, and challenges for sustaining and restoring high elevation five-needle white pine forests in western North America

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Robert E. Keane; Anna W. Schoettle

2011-01-01

Many ecologically important, five-needle white pine forests that historically dominated the high elevation landscapes of western North America are now being heavily impacted by mountain pine beetle (Dendroctonus spp.) outbreaks, the exotic disease white pine blister rust (WPBR), and altered high elevation fire regimes. Management intervention using specially designed...

Disease Outbreak News

Science.gov (United States)

... MERS-CoV) Pandemic (H1N1) 2009 Influenza at the Human-Animal Interface (HAI) Related documents WHO outbreak communication guide 2008 WHO outbreak communications guidelines Outbreak communication: ...

Disneyland Measles Outbreak

OpenAIRE

Palladino, Erica

2015-01-01

This media information sheet analyzes print and online coverage of the 2015 Disneyland measles outbreak. The frameworks that the media used to report on the outbreak presented vaccination as the only viable option from preventing the spread of measles. Reporting also failed to mention that the 2015 Disneyland measles outbreak was smaller than U.S. measles outbreaks in 2013 and 2014.

Fungal associates of the lodgepole pine beetle, Dendroctonus murrayanae.

Science.gov (United States)

Six, Diana L; de Beer, Z Wilhelm; Duong, Tuan A; Carroll, Allan L; Wingfield, Michael J

2011-08-01

Bark beetles are well known vectors of ophiostomatoid fungi including species of Ophiostoma, Grosmannia and Ceratocystis. In this study, the most common ophiostomatoid fungi associated with the lodgepole pine beetle, Dendroctonus murrayanae, were characterized. Pre-emergent and post-attack adult beetles were collected from lodgepole pines at four sites in British Columbia, Canada. Fungi were isolated from these beetles and identified using a combination of morphology and DNA sequence comparisons of five gene regions. In all four populations, Grosmannia aurea was the most common associate (74-100% of all beetles) followed closely by Ophiostoma abietinum (29-75%). Other fungi isolated, in order of their relative prevalence with individual beetles were an undescribed Leptographium sp. (0-13%), Ophiostoma ips (0-15%), Ophiostoma piliferum (0-11%), a Pesotum sp. (0-11%) and Ophiostoma floccosum (0-1%). Comparisons of the DNA sequences of Leptographium strains isolated in this study, with ex-type isolates of G. aurea, Grosmannia robusta, Leptographium longiclavatum, and Leptographium terebrantis, as well as with sequences from GenBank, revealed a novel lineage within the Grosmannia clavigera complex. This lineage included some of the D. murrayane isolates as well as several isolates from previous studies referred to as L. terebrantis. However, the monophyly of this lineage is not well supported and a more comprehensive study will be needed to resolve its taxonomic status as one or more novel taxa.

Impacts of beetle-induced forest mortality on carbon, water and nutrient cycling in the Rocky Mountains

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Elise Pendall; Brent Ewers; Urszula Norton; Paul Brooks; W. J. Massman; Holly Barnard; David Reed; Tim Aston; John Frank

2010-01-01

Conifer forests across western North America are undergoing a widespread mortality event mediated by an epidemic outbreak of bark beetles of the genus Dendroctonus and their associated bluestain fungi (Ophiostoma spp.). As of late 2009, beetles have impacted over 600,000 hectares in northern Colorado and southern Wyoming (US Forest Service aerial survey estimates),...

Building Resistance and Resilience: Regeneration Should Not be Left to Chance

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James N. Long

2018-05-01

Full Text Available Contemporary forest planning has tasked managers with developing goals associated with resistance and resilience. In practice, silviculturists use forest structure and tree species composition to characterize goals and desired future conditions, write prescriptions, and monitor outcomes associated with resistance and resilience. Although rarely discussed in the exploding literature relating to forest resistance and resilience, silvicultural regeneration methods are important and underutilized tools to meet these goals. We propose alternative silvicultural systems for building resistance and resilience to two common large-scale bark beetle disturbance agents in the Intermountain West, United States: mountain pine beetle (Dendroctonus ponderosae Hopkins and spruce beetle (Dendroctonus rufipennis Kirby. Shelterwood, and shelterwood-with-reserves, silvicultural systems provide the desirable facilitative characteristics of a mature overstory on maintaining advance reproduction and the establishment of new cohorts of desirable tree species. These also allow the timely regeneration of large treatment areas necessary to rapidly promote desired future conditions in the face of inevitable disturbance. When implemented proactively, regeneration treatments allow silviculturists to take advantage of currently existing vegetation for the creation of age class and tree species diversity. In general, these examples illustrate the need for proactive planning for regeneration in response to any disturbance where desired future conditions include particular species. Furthermore, we argue that timely silvicultural interventions that focus on regenerating trees may be a key factor in achieving goals relating to resilience to specific disturbance types. Waiting until after the disturbance has occurred could result in the lost opportunity to establish desired species composition or stand structure—and may well result in a considerable restoration challenge.

Response to host volatiles by native and introduced populations of Dendroctonus valens (Coleoptera: Curculionidae, Scolytinae) in North America and China.  Journal of Chemical Ecology 33: 131-146.

Science.gov (United States)

N. Erbilgin; S.R. Mori; J.H. Sun; J.D. Stein; D.R. Owen; L.D. Merrill; R. Campos Bolande; os; K.F. Raffa; T. Mendez Montiel; D.L. Wood; N.E.  Gillette

2007-01-01

Bark beetles (Coleoptera: Curculionidae, Scolytinae) have specialized feeding habits, and commonly colonize only one or a few closely related host genera in their geographical ranges. The red turpentine beetle, Dendroctonus valens LeConte, has a broad geographic distribution in North America and exploits volatile cues from a wide variety of pines...

Verbenone Plus reduces levels of tree mortality attributed to mountain pine beetle infestations in whitebark pine, a tree species of concern

Science.gov (United States)

Christopher J. Fettig; Beverly M. Bulaon; Christopher P. Dabney; Christopher J. Hayes; Stepehen R. McKelvey

2012-01-01

In western North America, recent outbreaks of the mountain pine beetle, Dendroctonus ponderosae Hopkins, have been severe, long-lasting and well-documented. We review previous research that led to the identification of Verbenone Plus, a novel four-component semiochemical blend [acetophenone, (E)-2-hexen-1-ol + (Z)-2-hexen-1-ol, and (–)-verbenone]...

Probability of infestation and extent of mortality models for mountain pine beetle in lodgepole pine forests in Colorado

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Jose F. Negron; Jennifer G. Klutsch

2017-01-01

The mountain pine beetle, Dendroctonus ponderosae Hopkins, is a significant agent of tree mortality in lodgepole pine (Pinus contorta Dougl. ex Loud.) forests throughout western North America. A large outbreak of mountain pine beetle caused extensive tree mortality in north-central Colorado beginning in the late 1990s. We use data from a network of plots established in...

Hidden in Plain sight: synthetic pheromone misleads beetles, protects trees

Science.gov (United States)

Paul Meznarich; Robert Progar

2015-01-01

In the last decade, pine forests throughout much of the western United States have been ravaged by the mountain pine beetle (Dendroctonus ponderosae). This bark beetle is native to the United States and has been responsible for massive tree kills in the past. The current outbreak, however, has been notably severe and wide ranging and the effects have been more dramatic...

Susceptibility of ponderosa pine, Pinus ponderosa (Dougl. Ex Laws.), to mountain pine beetle, Dendroctonus ponderosae Hopkins, attack in uneven-aged stands in the Black Hills of South Dakota and Wyoming USA

Science.gov (United States)

Jose F. Negron; Kurt Allen; Blaine Cook; John R. Withrow

2008-01-01

Mountain pine beetle, Dendroctonus ponderosae Hopkins can cause extensive tree mortality in ponderosa pine, Pinus ponderosa Dougl. ex Laws., forests in the Black Hills of South Dakota and Wyoming. Most studies that have examined stand susceptibility to mountain pine beetle have been conducted in even-aged stands. Land managers...

Seed release in serotinous lodgepole pine forests after mountain pine beetle outbreak.

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Teste, François P; Lieffers, Victor J; Landhausser, Simon M

2011-01-01

There are concerns that large-scale stand mortality due to mountain pine beetle (MPB) could greatly reduce natural regeneration of serotinous Rocky Mountain (RM) lodgepole pine (Pinus contorta var. latifolia) because the closed cones are held in place without the fire cue for cone opening. We selected 20 stands (five stands each of live [control], 3 years since MPB [3-yr-MPB], 6 years since MPB [6-yr-MPB], and 9 years since MPB [9-yr-MPB] mortality) in north central British Columbia, Canada. The goal was to determine partial loss of serotiny due to fall of crown-stored cones via breakage of branches and in situ opening of canopy cones throughout the 2008 and 2009 growing seasons. We also quantified seed release by the opening of forest-floor cones, loss of seed from rodent predation, and cone burial. Trees killed by MPB three years earlier dropped approximately 3.5 times more cones via branch breakage compared to live stands. After six years, MPB-killed stands had released 45% of their canopy seed bank through cone opening, cone fall due to breakage, and squirrel predation. Further losses of canopy seed banks are expected with time since we found 9-yr-MPB stands had 38% more open canopy cones. This was countered by the development of a modest forest-floor seed bank (6% of the original canopy seed bank) from burial of cones; this seed bank may be ecologically important if a fire or anthropogenic disturbance reexposes these cones. If adequate levels of regeneration are to occur, disturbances to create seedbeds must occur shortly after tree mortality, before the seed banks are lost. Our findings also suggest that the sustained seed rain (over at least nine years) after MPB outbreak may be beneficial for population growth of ground-foraging vertebrates. Our study adds insight to the seed ecology of serotinous pines under a potentially continental-wide insect outbreak, threatening vast forests adapted to regeneration after fire. Key words: biotic disturbance; cone

The Effect of Water Limitation on Volatile Emission, Tree Defense Response, and Brood Success of Dendroctonus ponderosae in Two Pine Hosts, Lodgepole, and Jack Pine

OpenAIRE

Lusebrink, Inka; Erbilgin, Nadir; Evenden, Maya L.

2016-01-01

The mountain pine beetle (MPB; Dendroctonus ponderosae) has recently expanded its range from lodgepole pine forest into the lodgepole × jack pine hybrid zone in central Alberta, within which it has attacked pure jack pine. This study tested the effects of water limitation on tree defense response of mature lodgepole and jack pine (Pinus contorta and Pinus banksiana) trees in the field. Tree defense response was initiated by inoculation of trees with the MPB-associated fungus Grosmannia clavig...

Comparison of lodgepole and jack pine resin chemistry: implications for range expansion by the mountain pine beetle, Dendroctonus ponderosae (Coleoptera: Curculionidae

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Erin L. Clark

2014-02-01

Full Text Available The mountain pine beetle, Dendroctonus ponderosae, is a significant pest of lodgepole pine in British Columbia (BC, where it has recently reached an unprecedented outbreak level. Although it is native to western North America, the beetle can now be viewed as a native invasive because for the first time in recorded history it has begun to reproduce in native jack pine stands within the North American boreal forest. The ability of jack pine trees to defend themselves against mass attack and their suitability for brood success will play a major role in the success of this insect in a putatively new geographic range and host. Lodgepole and jack pine were sampled along a transect extending from the beetle’s historic range (central BC to the newly invaded area east of the Rocky Mountains in north-central Alberta (AB in Canada for constitutive phloem resin terpene levels. In addition, two populations of lodgepole pine (BC and one population of jack pine (AB were sampled for levels of induced phloem terpenes. Phloem resin terpenes were identified and quantified using gas chromatography. Significant differences were found in constitutive levels of terpenes between the two species of pine. Constitutive α-pinene levels – a precursor in the biosynthesis of components of the aggregation and antiaggregation pheromones of mountain pine beetle – were significantly higher in jack pine. However, lower constitutive levels of compounds known to be toxic to bark beetles, e.g., 3-carene, in jack pine suggests that this species could be poorly defended. Differences in wounding-induced responses for phloem accumulation of five major terpenes were found between the two populations of lodgepole pine and between lodgepole and jack pine. The mountain pine beetle will face a different constitutive and induced phloem resin terpene environment when locating and colonizing jack pine in its new geographic range, and this may play a significant role in the ability of the

Comparison of lodgepole and jack pine resin chemistry: implications for range expansion by the mountain pine beetle, Dendroctonus ponderosae (Coleoptera: Curculionidae).

Science.gov (United States)

Clark, Erin L; Pitt, Caitlin; Carroll, Allan L; Lindgren, B Staffan; Huber, Dezene P W

2014-01-01

The mountain pine beetle, Dendroctonus ponderosae, is a significant pest of lodgepole pine in British Columbia (BC), where it has recently reached an unprecedented outbreak level. Although it is native to western North America, the beetle can now be viewed as a native invasive because for the first time in recorded history it has begun to reproduce in native jack pine stands within the North American boreal forest. The ability of jack pine trees to defend themselves against mass attack and their suitability for brood success will play a major role in the success of this insect in a putatively new geographic range and host. Lodgepole and jack pine were sampled along a transect extending from the beetle's historic range (central BC) to the newly invaded area east of the Rocky Mountains in north-central Alberta (AB) in Canada for constitutive phloem resin terpene levels. In addition, two populations of lodgepole pine (BC) and one population of jack pine (AB) were sampled for levels of induced phloem terpenes. Phloem resin terpenes were identified and quantified using gas chromatography. Significant differences were found in constitutive levels of terpenes between the two species of pine. Constitutive α-pinene levels - a precursor in the biosynthesis of components of the aggregation and antiaggregation pheromones of mountain pine beetle - were significantly higher in jack pine. However, lower constitutive levels of compounds known to be toxic to bark beetles, e.g., 3-carene, in jack pine suggests that this species could be poorly defended. Differences in wounding-induced responses for phloem accumulation of five major terpenes were found between the two populations of lodgepole pine and between lodgepole and jack pine. The mountain pine beetle will face a different constitutive and induced phloem resin terpene environment when locating and colonizing jack pine in its new geographic range, and this may play a significant role in the ability of the insect to persist in

Response of high elevation rocky mountain (Wyoming, USA) forest carbon dioxide and water vapor fluxes to a bark beetle epidemic

Science.gov (United States)

Frank, J. M.; Massman, W. J.

2010-12-01

The GLEES-AmeriFlux site is located in the Snowy Range Mountains, Medicine Bow National Forest, southeastern Wyoming [41o21’52” N, 106o14’22” W; 3190 m MSL]. Since November 1999, measurements of surface energy balance, momentum, CO2, and water vapor eddy-covariance fluxes have been made at the subalpine site which is dominated by an Engelmann spruce (Picea engelmannii) and subalpine fir (Abies lasiocarpa) forest. An ongoing spruce beetle (Dendroctonus rufipennis) outbreak has caused significant tree mortality in the forest over the past few years. In this study we investigate the impact of this bark beetle epidemic on the net ecosystem exchange of carbon (NEE) and evapotranspiration (ET); to achieve this goal we quantify the impact of significant eddy-covariance measurement issues. From 2006 to 2009 the magnitude of NEE decreased steadily by an average of 0.8 MgC ha-1 yr-1, which resulted in the reduction of the annual C sink from 2.9 to 0.6 MgC ha-1 yr-1. Over this time ET decreased steadily from 72.2 to 58.3 cm yr-1. The importance of the Webb-Pearman-Leuning (WPL) correction due to self-heating associated with open-path CO2/H2O analyzers was quantified by applying a thermodynamic model based on (1) a generalized model for instrument surface temperatures and (2) measured and site-specific modeled surface temperatures. The increase in measured NEE (towards being a net C source) due to the generalized model (1) was 2.2 MgC ha-1 yr-1, while the site specific corrections (2) accounted for an increase of 2.8 MgC ha-1 yr-1. The self-heating correction was much less important with ET measurements, increasing the measured flux by 0.5 cm yr-1, regardless of which method of determining surface temperature was used.

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report

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Mohammed A. Soghaier

2013-10-01

Full Text Available Summary: Introduction: Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever (VHF, which is considered to be a very serious illness. Yellow Fever (YF outbreaks in Sudan have been reported from the 1940s through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. Objective: To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. Methodology: >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. Results: The field investigation confirmed the outbreak and identified its cause to be YF. Conclusion: National surveillance systems should be strong enough to detect VHFs in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios (CFRs are usually very high among the index cases. Keywords: Yellow Fever, Sudan, Darfur, VHFs, Soghaier

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report.

Science.gov (United States)

Soghaier, Mohammed A; Hagar, Ahmed; Abbas, Mohammed A; Elmangory, Mutasim M; Eltahir, Khalid M; Sall, Amadou A

2013-10-01

Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever (VHF), which is considered to be a very serious illness. Yellow Fever (YF) outbreaks in Sudan have been reported from the 1940s through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. The field investigation confirmed the outbreak and identified its cause to be YF. National surveillance systems should be strong enough to detect VHFs in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios (CFRs) are usually very high among the index cases. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Two listeria outbreaks caused by smoked fish consumption-using whole-genome sequencing for outbreak investigations

DEFF Research Database (Denmark)

Gillesberg Lassen, S.; Ethelberg, S.; Björkman, J. T.

2016-01-01

low-intensity, extended time-period outbreaks and link them to food products from two different contaminated production facilities with sufficient strength for food authorities to intervene on. Cold smoked and gravad fish constitute risk products and may be responsible for more listeriosis cases than......Listeria monocytogenes may contaminate and persist in food production facilities and cause repeated, seemingly sporadic, illnesses over extended periods of time. We report on the investigation of two such concurrent outbreaks. We compared patient isolates and available isolates from foods and food...... polymorphism differences. We performed routine food consumption interviews of L. monocytogenes patients and compared outbreak cases with sporadic cases. Two outbreaks were defined, each consisting of ten outbreak cases in the period 2013-15. Seven outbreak cases and a fetus in gestational week 38 died...

Incentives for reporting disease outbreaks.

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Ramanan Laxminarayan

Full Text Available BACKGROUND: Countries face conflicting incentives to report infectious disease outbreaks. Reports of outbreaks can prompt other countries to impose trade and travel restrictions, which has the potential to discourage reporting. However, reports can also bring medical assistance to contain the outbreak, including access to vaccines. METHODS: We compiled data on reports of meningococcal meningitis to the World Health Organization (WHO from 54 African countries between 1966 and 2002, a period is marked by two events: first, a large outbreak reported from many countries in 1987 associated with the Hajj that resulted in more stringent requirements for meningitis vaccination among pilgrims; and second, another large outbreak in Sub-Saharan Africa in 1996 that led to a new international mechanism to supply vaccines to countries reporting a meningitis outbreak. We used fixed-effects regression modeling to statistically estimate the effect of external forcing events on the number of countries reporting cases of meningitis to WHO. FINDINGS: We find that the Hajj vaccination requirements started in 1988 were associated with reduced reporting, especially among countries with relatively fewer cases reported between 1966 and 1979. After the vaccine provision mechanism was in place in 1996, reporting among countries that had previously not reported meningitis outbreaks increased. INTERPRETATION: These results indicate that countries may respond to changing incentives to report outbreaks when they can do so. In the long term, these incentives are likely to be more important than surveillance assistance in prompt reporting of outbreaks.

Selection tool for foodborne norovirus outbreaks.

Science.gov (United States)

Verhoef, Linda P B; Kroneman, Annelies; van Duynhoven, Yvonne; Boshuizen, Hendriek; van Pelt, Wilfrid; Koopmans, Marion

2009-01-01

Detection of pathogens in the food chain is limited mainly to bacteria, and the globalization of the food industry enables international viral foodborne outbreaks to occur. Outbreaks from 2002 through 2006 recorded in a European norovirus surveillance database were investigated for virologic and epidemiologic indicators of food relatedness. The resulting validated multivariate logistic regression model comparing foodborne (n = 224) and person-to-person (n = 654) outbreaks was used to create a practical web-based tool that can be limited to epidemiologic parameters for nongenotyping countries. Non-genogroup-II.4 outbreaks, higher numbers of cases, and outbreaks in restaurants or households characterized (sensitivity = 0.80, specificity = 0.86) foodborne outbreaks and reduced the percentage of outbreaks requiring source-tracing to 31%. The selection tool enabled prospectively focused follow-up. Use of this tool is likely to improve data quality and strain typing in current surveillance systems, which is necessary for identification of potential international foodborne outbreaks.

Outbreak Column 16: Cognitive errors in outbreak decision making.

Science.gov (United States)

Curran, Evonne T

2015-01-01

During outbreaks, decisions must be made without all the required information. People, including infection prevention and control teams (IPCTs), who have to make decisions during uncertainty use heuristics to fill the missing data gaps. Heuristics are mental model short cuts that by-and-large enable us to make good decisions quickly. However, these heuristics contain biases and effects that at times lead to cognitive (thinking) errors. These cognitive errors are not made to deliberately misrepresent any given situation; we are subject to heuristic biases when we are trying to perform optimally. The science of decision making is large; there are over 100 different biases recognised and described. Outbreak Column 16 discusses and relates these heuristics and biases to decision making during outbreak prevention, preparedness and management. Insights as to how we might recognise and avoid them are offered.

Forecasting rodent outbreaks in Africa

DEFF Research Database (Denmark)

Leirs, Herwig; Verhagen, Ron; Verheyen, Walter

1996-01-01

1. Rainfall data were collated for years preceding historical outbreaks of Mastomys rats in East Africa in order to test the hypothesis that such outbreaks occur after long dry periods. 2. Rodent outbreaks were generally not preceded by long dry periods. 3. Population dynamics of Mastomys...... natalensis rats in Tanzania are significantly affected by the distribution of rainfall during the rainy season. 4. All previous rodent outbreaks in Tanzania were preceded by abundant rainfall early in the rainy season, i.e, towards the end of the year. 5. A flow chart is constructed to assess the likelihood...

TOWARDS MODELING DISEASE OUTBREAK NOTIFICATION SYSTEMS

OpenAIRE

Farag Azzedin; Jaweed Yazdani,; Salahadin Adam; Mustafa Ghaleb

2014-01-01

Disease outbreak detection, monitoring and notification systems play an important role in assessing threats to public health since disease outbreaks are becoming increasingly common world-wide. There are several systems in use around the world, with coverage of national, international and global disease outbreaks. These systems use different taxonomies and classifications for the detection and prioritization of potential disease outbreaks. In this paper, we study and analyze th...

A Hospital-wide Outbreak of Serratia marcescens, and Ishikawa's “Fishbone” Analysis to Support Outbreak Control

Science.gov (United States)

Vetter, Luzia; Schuepfer, Guido; Kuster, Stefan P.

2016-01-01

A nosocomial outbreak of Serratia marcescens in respiratory samples predominantly from patients in a surgical intensive care unit is reported. Most of these patients were cardiac surgical patients. Initially, a vigorous but inconclusive investigation was implemented on the basis of standardized (according the US Centers for Disease Control and Prevention) steps of outbreak investigation. Then, a systemic quality management approach with “fishbone” analysis was added. As a consequence, plausible causes for the outbreak were identified: (i) S marcescens was found on the transesophageal echocardiography probe used during cardiac surgery; and (ii) the quality of the surface disinfection was insufficient due to multiple reasons and was completely reengineered. In conclusion, in addition to the standardized steps of outbreak investigation, the complementary use of quality management tools such as the Ishikawa “fishbone” analysis is helpful for outbreak control. The complete reengineering of the disinfectant procurement and logistics is assumed to have been the most effective measure to control the described outbreak. PMID:26783861

Dengue disease outbreak definitions are implicitly variable

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Oliver J. Brady

2015-06-01

Full Text Available Infectious diseases rarely exhibit simple dynamics. Outbreaks (defined as excess cases beyond response capabilities have the potential to cause a disproportionately high burden due to overwhelming health care systems. The recommendations of international policy guidelines and research agendas are based on a perceived standardised definition of an outbreak characterised by a prolonged, high-caseload, extra-seasonal surge. In this analysis we apply multiple candidate outbreak definitions to reported dengue case data from Brazil to test this assumption. The methods identify highly heterogeneous outbreak characteristics in terms of frequency, duration and case burden. All definitions identify outbreaks with characteristics that vary over time and space. Further, definitions differ in their timeliness of outbreak onset, and thus may be more or less suitable for early intervention. This raises concerns about the application of current outbreak guidelines for early warning/identification systems. It is clear that quantitatively defining the characteristics of an outbreak is an essential prerequisite for effective reactive response. More work is needed so that definitions of disease outbreaks can take into account the baseline capacities of treatment, surveillance and control. This is essential if outbreak guidelines are to be effective and generalisable across a range of epidemiologically different settings.

Salmonellosis outbreak due to chicken contact leading to a foodborne outbreak associated with infected delicatessen workers.

Science.gov (United States)

Hedican, Erin; Miller, Ben; Ziemer, Brian; LeMaster, Pam; Jawahir, Selina; Leano, Fe; Smith, Kirk

2010-08-01

Salmonella is the most common bacterial cause of foodborne outbreaks in the United States. Starting in June 2007, investigation of a cluster of Salmonella Montevideo cases with indistinguishable pulsed-field gel electrophoresis (PFGE) patterns resulted in the identification of an outbreak associated with contact with chickens purchased from a single hatchery. Nine Minnesota cases from May through August 2007 were part of this outbreak. Cases with the outbreak PFGE pattern of Salmonella Montevideo continued to occur in Minnesota after August, but none of these cases reported chicken contact. The majority of these cases resided in the same town in rural Minnesota. Routine interviews revealed that all cases from these counties purchased groceries from the same local grocery store, with two specifically reporting consuming items from the grocery store delicatessen in the week before illness. As a result, an investigation into the delicatessen was initiated. Illness histories and stool samples were collected from all delicatessen employees, and food and environmental samples were collected. None of the employees reported experiencing recent gastrointestinal symptoms, but the outbreak PFGE subtype of Salmonella Montevideo was identified from stool from two food workers. Food and environmental samples collected tested negative for Salmonella. One of the positive employees reported having chickens at home, but the animals did not test positive for Salmonella. The positive food workers were excluded from work until they had two consecutive negative stool cultures for Salmonella. There was no evidence of ongoing transmission thereafter. This was an outbreak of Salmonella Montevideo infections that began as an animal-contact-associated outbreak which subsequently resulted in a foodborne outbreak associated with infected food workers. These outbreaks illustrate the complex epidemiology of salmonellosis.

Detecting and Responding to a Dengue Outbreak: Evaluation of Existing Strategies in Country Outbreak Response Planning

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Julia Harrington

2013-01-01

Full Text Available Background. Dengue outbreaks are occurring with increasing frequency and intensity. Evidence-based epidemic preparedness and effective response are now a matter of urgency. Therefore, we have analysed national and municipal dengue outbreak response plans. Methods. Thirteen country plans from Asia, Latin America and Australia, and one international plan were obtained from the World Health Organization. The information was transferred to a data analysis matrix where information was extracted according to predefined and emerging themes and analysed for scope, inconsistencies, omissions, and usefulness. Findings. Outbreak response planning currently has a considerable number of flaws. Outbreak governance was weak with a lack of clarity of stakeholder roles. Late timing of responses due to poor surveillance, a lack of combining routine data with additional alerts, and lack of triggers for initiating the response weakened the functionality of plans. Frequently an outbreak was not defined, and early response mechanisms based on alert signals were neglected. There was a distinct lack of consideration of contextual influences which can affect how an outbreak detection and response is managed. Conclusion. A model contingency plan for dengue outbreak prediction, detection, and response may help national disease control authorities to develop their own more detailed and functional context specific plans.

Seasonal shifts in accumulation of glycerol biosynthetic gene transcripts in mountain pine beetle, Dendroctonus ponderosae Hopkins (Coleoptera: Curculionidae, larvae

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Jordie D. Fraser

2017-06-01

Full Text Available Winter mortality is a major factor regulating population size of the mountain pine beetle, Dendroctonus ponderosae Hopkins (Coleoptera: Curculionidae. Glycerol is the major cryoprotectant in this freeze intolerant insect. We report findings from a gene expression study on an overwintering mountain pine beetle population over the course of 35 weeks. mRNA transcript levels suggest glycerol production in the mountain pine beetle occurs through glycogenolytic, gluconeogenic and potentially glyceroneogenic pathways, but not from metabolism of lipids. A two-week lag period between fall glycogen phosphorylase transcript and phosphoenolpyruvate carboxykinase transcript up-regulation suggests that gluconeogenesis serves as a secondary glycerol-production process, subsequent to exhaustion of the primary glycogenolytic source. These results provide a first look at the details of seasonal gene expression related to the production of glycerol in the mountain pine beetle.

A methodology for assessing annual risk of southern pine beetle outbreaks across the southern region using pheromone traps

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Ronald F Billings; William W. Upton

2010-01-01

An operational system to forecast infestation trends (increasing, static, declining) and relative population levels (high, moderate, low) of the southern pine beetle (SPB), Dendroctonus frontalis, has been implemented in the Southern and Eastern United States. Numbers of dispersing SPB and those of a major predator (the clerid beetle, ...

Pre-outbreak forest conditions mediate the effects of spruce beetle outbreaks on fuels in subalpine forests of Colorado.

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Mietkiewicz, Nathan; Kulakowski, Dominik; Veblen, Thomas T

2018-03-01

Over the past 30 years, forest disturbances have increased in size, intensity, and frequency globally, and are predicted to continue increasing due to climate change, potentially relaxing the constraints of vegetation properties on disturbance regimes. However, the consequences of the potentially declining importance of vegetation in determining future disturbance regimes are not well understood. Historically, bark beetles preferentially attack older trees and stands in later stages of development. However, as climate warming intensifies outbreaks by promoting growth of beetle populations and compromising tree defenses, smaller diameter trees and stands in early stages of development now are being affected by outbreaks. To date, no study has considered how stand age and other pre-outbreak forest conditions mediate the effects of outbreaks on surface and aerial fuel arrangements. We collected fuels data across a chronosequence of post-outbreak sites affected by spruce beetle (SB) between the 1940s and the 2010s, stratified by young (130 yr) post-fire stands. Canopy and surface fuel loads were calculated for each tree and stand, and available crown fuel load, crown bulk density, and canopy bulk densities were estimated. Canopy bulk density and density of live canopy individuals were reduced in all stands affected by SB, though foliage loss was proportionally greater in old stands as compared to young stands. Fine surface fuel loads in young stands were three times greater shortly (fuels decreased to below endemic (i.e., non-outbreak) levels. In both young and old stands, the net effect of SB outbreaks during the 20th and 21st centuries reduced total canopy fuels and increased stand-scale spatial heterogeneity of canopy fuels following outbreak. Importantly, the decrease in canopy fuels following outbreaks was greater in young post-fire stands than in older stands, suggesting that SB outbreaks may more substantially reduce risk of active crown fire when they affect

Whitebark pine mortality related to white pine blister rust, mountain pine beetle outbreak, and water availability

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Shanahan, Erin; Irvine, Kathryn M.; Thoma, David P.; Wilmoth, Siri K.; Ray, Andrew; Legg, Kristin; Shovic, Henry

2016-01-01

Whitebark pine (Pinus albicaulis) forests in the western United States have been adversely affected by an exotic pathogen (Cronartium ribicola, causal agent of white pine blister rust), insect outbreaks (Dendroctonus ponderosae, mountain pine beetle), and drought. We monitored individual trees from 2004 to 2013 and characterized stand-level biophysical conditions through a mountain pine beetle epidemic in the Greater Yellowstone Ecosystem. Specifically, we investigated associations between tree-level variables (duration and location of white pine blister rust infection, presence of mountain pine beetle, tree size, and potential interactions) with observations of individual whitebark pine tree mortality. Climate summaries indicated that cumulative growing degree days in years 2006–2008 likely contributed to a regionwide outbreak of mountain pine beetle prior to the observed peak in whitebark mortality in 2009. We show that larger whitebark pine trees were preferentially attacked and killed by mountain pine beetle and resulted in a regionwide shift to smaller size class trees. In addition, we found evidence that smaller size class trees with white pine blister rust infection experienced higher mortality than larger trees. This latter finding suggests that in the coming decades white pine blister rust may become the most probable cause of whitebark pine mortality. Our findings offered no evidence of an interactive effect of mountain pine beetle and white pine blister rust infection on whitebark pine mortality in the Greater Yellowstone Ecosystem. Interestingly, the probability of mortality was lower for larger trees attacked by mountain pine beetle in stands with higher evapotranspiration. Because evapotranspiration varies with climate and topoedaphic conditions across the region, we discuss the potential to use this improved understanding of biophysical influences on mortality to identify microrefugia that might contribute to successful whitebark pine conservation

Cost of a measles outbreak in a remote island economy: 2014 Federated States of Micronesia measles outbreak.

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Pike, Jamison; Tippins, Ashley; Nyaku, Mawuli; Eckert, Maribeth; Helgenberger, Louisa; Underwood, J Michael

2017-10-13

After 20years with no reported measles cases, on May 15, 2014 the Centers for Disease Control and Prevention (CDC) was notified of two cases testing positive for measles-specific immunoglobulin M (IgM) antibodies in the Federated States of Micronesia (FSM). Under the Compact of Free Association, FSM receives immunization funding and technical support from the United States (US) domestic vaccination program managed by the Centers for Disease Control and Prevention (CDC). In a collaborative effort, public health officials and volunteers from FSM and the US government worked to respond and contain the measles outbreak through an emergency mass vaccination campaign, contact tracing, and other outbreak investigation activities. Contributions were also made by United Nations Children's Emergency Fund (UNICEF) and World Health Organization (WHO). Total costs incurred as a result of the outbreak were nearly $4,000,000; approximately $10,000 per case. Direct medical costs (≈$141,000) were incurred in the treatment of those individuals infected, as well as lost productivity of the infected and informal caregivers (≈$250,000) and costs to contain the outbreak (≈$3.5 million). We assessed the economic burden of the 2014 measles outbreak to FSM, as well as the economic responsibilities of the US. Although the US paid the majority of total costs of the outbreak (≈67%), examining each country's costs relative to their respective economy illustrates a far greater burden to FSM. We demonstrate that while FSM was heavily assisted by the US in responding to the 2014 Measles Outbreak, the outbreak significantly impacted their economy. FSM's economic burden from the outbreak is approximately equivalent to their entire 2016 Fiscal Year budget dedicated to education. Published by Elsevier Ltd.

Coccidioidomycosis Outbreaks, United States and Worldwide, 1940-2015.

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Freedman, Michael; Jackson, Brendan R; McCotter, Orion; Benedict, Kaitlin

2018-03-01

Coccidioidomycosis causes substantial illness and death in the United States each year. Although most cases are sporadic, outbreaks provide insight into the clinical and environmental features of coccidioidomycosis, high-risk activities, and the geographic range of Coccidioides fungi. We identified reports published in English of 47 coccidioidomycosis outbreaks worldwide that resulted in 1,464 cases during 1940-2015. Most (85%) outbreaks were associated with environmental exposures; the 2 largest outbreaks resulted from an earthquake and a large dust storm. More than one third of outbreaks occurred in areas where the fungus was not previously known to be endemic, and more than half of outbreaks involved occupational exposures. Coccidioidomycosis outbreaks can be difficult to detect and challenging to prevent given the unknown effectiveness of environmental control methods and personal protective equipment; therefore, increased awareness of coccidioidomycosis outbreaks is needed among public health professionals, healthcare providers, and the public.

Gastroenteritis outbreaks on cruise ships

DEFF Research Database (Denmark)

Mouchtouri, Varvara A; Verykouki, Eleni; Zamfir, Dumitru

2017-01-01

When an increased number of acute gastroenteritis (AG) cases is detected among tourists staying at the same accommodation, outbreak management plans must be activated in a timely manner to prevent large outbreaks. Syndromic surveillance data collected between 1 January 2010 and 31 December 2013...

Measles outbreak linked to European B3 outbreaks, Wales, United Kingdom, 2017.

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Currie, Jonny; Davies, Llion; McCarthy, Joanne; Perry, Malorie; Moore, Catherine; Cottrell, Simon; Bowley, Mererid; Williams, Chris; Shankar, Ananda Giri; Stiff, Rhianwen

2017-10-01

The United Kingdom achieved interrupted endemic measles transmission for 36 months in 2016. Despite this, ongoing challenges from sporadic measles cases typically imported from abroad remain. We summarise a B3 measles genotype outbreak in south-east Wales occurring between May and September 2017, linked with other European outbreaks, and lessons learnt. Seventeen confirmed cases and one probable case occurred principally in education and healthcare-settings. Six confirmed cases attended healthcare settings when infectious, without being isolated.

Norovirus: U.S. Trends and Outbreaks

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... harvested from contaminated water and raspberries irrigated with contaminated water have caused norovirus outbreaks. Norovirus on Cruise Ships Over 90% of diarrheal disease outbreaks on cruise ships are caused by norovirus ( ...

Establishing a milkborne disease outbreak profile: potential food defense implications.

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Newkirk, Ryan; Hedberg, Craig; Bender, Jeff

2011-03-01

The main objectives of this study were to establish baseline characteristics for milkborne outbreaks, establish an expected milkborne outbreak profile, and identify potential indicators of food terrorism. This study used 1990-2006 data from the Centers for Disease Control and Prevention Annual Listings of Disease Outbreaks and the Foodborne Outbreak Database (FOOD) to establish epidemiologic baseline characteristics for disease outbreaks associated with fluid milk. FOOD data from 2007 were used to qualitatively validate the potential of the baseline characteristics and the expected outbreak profile. Eighty-three fluid milkborne outbreaks were reported between 1990 and 2006, resulting in 3621 illnesses. The mean number of illnesses per outbreak was 43.6 (illness range: 2-1644). Consumption of unpasteurized milk was associated with 55.4% of reported outbreaks. Campylobacter spp., Escherichia coli, and Salmonella spp. caused 51.2%, 10.8%, and 9.6% of reported outbreaks, respectively. Private homes accounted for 41.0% of outbreak locations. Number ill, outbreak location, and etiology were the primary characteristics which could signal a potential intentional contamination event. In 2007, one pasteurized milk outbreak caused by Listeria was flagged as aberrative compared with the expected outbreak profile. The creation and dissemination of expected outbreak profiles and epidemiologic baseline characteristics allow public health and Homeland Security officials to quickly assess the potential of intentional food contamination. A faster public health and medical system response can result in decreased morbidity and mortality.

Epidemiology of restaurant-associated foodborne disease outbreaks, United States, 1998-2013.

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Angelo, K M; Nisler, A L; Hall, A J; Brown, L G; Gould, L H

2017-02-01

Although contamination of food can occur at any point from farm to table, restaurant food workers are a common source of foodborne illness. We describe the characteristics of restaurant-associated foodborne disease outbreaks and explore the role of food workers by analysing outbreaks associated with restaurants from 1998 to 2013 reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. We identified 9788 restaurant-associated outbreaks. The median annual number of outbreaks was 620 (interquartile range 618-629). In 3072 outbreaks with a single confirmed aetiology reported, norovirus caused the largest number of outbreaks (1425, 46%). Of outbreaks with a single food reported and a confirmed aetiology, fish (254 outbreaks, 34%) was most commonly implicated, and these outbreaks were commonly caused by scombroid toxin (219 outbreaks, 86% of fish outbreaks). Most outbreaks (79%) occurred at sit-down establishments. The most commonly reported contributing factors were those related to food handling and preparation practices in the restaurant (2955 outbreaks, 61%). Food workers contributed to 2415 (25%) outbreaks. Knowledge of the foods, aetiologies, and contributing factors that result in foodborne disease restaurant outbreaks can help guide efforts to prevent foodborne illness.

Respuesta kairomonal de coleópteros asociados a Dendroctonus frontalis y dos especies de Ips (Coleoptera: Curculionidae en bosques de Chiapas, México Kairomonal response of coleopterans associated with Dendroctonus frontalis and two Ips species (Coleoptera: Curculionidae in forest of Chiapas, Mexico

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Bernardo Domínguez-Sánchez

2008-06-01

Full Text Available Se evaluó la diversidad de escarabajos descortezadores y la respuesta diferencial de sus coleópteros asociados a feromonas comerciales de agregación, en bosques de pino del estado de Chiapas, México. Durante los meses de junio a octubre del 2006, se colocaron 40 trampas multiembudo tipo Lindgren cebadas con las feromonas racémicas frontalina, ipsenol e ipsdienol y un testigo (sin feromona. La captura fue más abundante para los escarabajos descortezadores Dendroctonus frontalis (Zimmermann con frontalina, y de Ips spp. con ipsenol e ipsdienol. Se registró respuesta kairomonal específica de los depredadores Temnochila chlorodia (Mannerheim, Enoclerus ablusus (Barr y Elacatis sp. hacia las feromonas de agregación. Tanto para descortezadores como para depredadores, las mayores abundancias fueron registradas durante el verano y a comienzos del otoño. Temmnochila chlorodia exhibió una atracción diferencial hacia los semioquímicos evaluados, mientras que E. ablusus, Elacatis sp. y Leptostylus sp. fueron atraídos principalmente por las feromonas ipsenol e ipsdienol. Además, por primera vez para México se determinó la respuesta kairomonal del fitófago Leptostylus sp. (Cerambycidae. Estos resultados indican que hay una comunicación intra e inter específica entre los escarabajos descortezadores y sus especies asociadas que promueven interacciones de competencia y depredación.We assessed the bark beetle diversity and the response of associated predators to aggregation pheromones in pine forests in Chiapas, Mexico. From June to October 2006, 40 Lindgren funnel traps were established with different baits that included frontalin, ipsenol and ipsdienol pheromones and a control (without pheromone. We registered the attractiveness of frontalin to the bark beetle Dendroctonus frontalis (Zimmermann, and ipsenol and ipsdienol to Ips spp. Kairomonal specific response of the predators Temnochila chlorodia (Mannerheim, Enoclerus ablusus (Barr and

Surveillance for foodborne disease outbreaks - United States, 1998-2008.

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Gould, L Hannah; Walsh, Kelly A; Vieira, Antonio R; Herman, Karen; Williams, Ian T; Hall, Aron J; Cole, Dana

2013-06-28

Foodborne diseases cause an estimated 48 million illnesses each year in the United States, including 9.4 million caused by known pathogens. Foodborne disease outbreak surveillance provides valuable insights into the agents and foods that cause illness and the settings in which transmission occurs. CDC maintains a surveillance program for collection and periodic reporting of data on the occurrence and causes of foodborne disease outbreaks in the United States. This surveillance system is the primary source of national data describing the numbers of illnesses, hospitalizations, and deaths; etiologic agents; implicated foods; contributing factors; and settings of food preparation and consumption associated with recognized foodborne disease outbreaks in the United States. 1998-2008. The Foodborne Disease Outbreak Surveillance System collects data on foodborne disease outbreaks, defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. Public health agencies in all 50 states, the District of Columbia, U.S. territories, and Freely Associated States have primary responsibility for identifying and investigating outbreaks and use a standard form to report outbreaks voluntarily to CDC. During 1998-2008, reporting was made through the electronic Foodborne Outbreak Reporting System (eFORS). During 1998-2008, CDC received reports of 13,405 foodborne disease outbreaks, which resulted in 273,120 reported cases of illness, 9,109 hospitalizations, and 200 deaths. Of the 7,998 outbreaks with a known etiology, 3,633 (45%) were caused by viruses, 3,613 (45%) were caused by bacteria, 685 (5%) were caused by chemical and toxic agents, and 67 (1%) were caused by parasites. Among the 7,724 (58%) outbreaks with an implicated food or contaminated ingredient reported, 3,264 (42%) could be assigned to one of 17 predefined commodity categories: fish, crustaceans, mollusks, dairy, eggs, beef, game, pork, poultry, grains/beans, oils

Reporting and Surveillance for Norovirus Outbreaks

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... Vaccine Surveillance Network (NVSN) Foodborne Diseases Active Surveillance Network (FoodNet) National Outbreak Reporting System (NORS) Estimates of Foodborne Illness in the United States CDC's Vessel Sanitation Program CDC Feature: Surveillance for Norovirus Outbreaks Top ...

Large outbreak caused by methicillin resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital--from outbreak control to outbreak prevention.

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Thomas Grönthal

Full Text Available INTRODUCTION: The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 - January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. METHODS: Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. RESULTS: Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3-17.0, P = 0.0003, antimicrobial treatment (OR = 3.8, CI95% 1.0-13.9, P = 0.0442, cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1-1.6, P = 0.0007 or in the surgery ward (OR = 1.1, CI95% 1.0-1.3, P = 0.0401. Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. CONCLUSION: Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring MRSP. Rigorous control

Salmonella outbreak among railway and airline passengers.

Science.gov (United States)

Hatakka, M

1992-01-01

A widespread outbreak by Salmonella infantis, infecting a total of 226 people, occurred in Finland at the beginning of August 1986. Of those infected, 107 were railway passengers, 91 were airline passengers and 28 were employed in a food processing establishment. The outbreak among the railway passengers was caused by egg sandwiches, the airline passengers were infected by a meal served on board and the catering employees by the breakfast served in the establishment. The outbreak was caused by food prepared in the establishment's kitchen. The employees' breakfasts had probably been contaminated by an employee who was a symptom-free Salmonella infantis carrier, and a number of the employees subsequently became infected, leading to widespread contamination of the food prepared in the establishment. The spread of the outbreak was further influenced by a heatwave at the time and by shortcomings in the cold storage facilities. The kitchen's hygiene supervision and the quality control of its output were reorganized after the outbreak.

Designing and implementing an electronic dashboard for disease outbreaks response - Case study of the 2013-2014 Somalia Polio outbreak response dashboard.

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Kamadjeu, Raoul; Gathenji, Caroline

2017-01-01

In April 2013, a case of wild polio virus (WPV) was detected in the Somalia capital Mogadishu. This inaugurated what is now referred to as the 2013-2014 Horn of Africa Polio outbreak with cases reported in Somalia, Kenya and Ethiopia. By the notification of the last polio case in August 2014, 223 cases of WPV had been reported in Somalia, Kenya and Ethiopia of which 199 in Somalia alone. The outbreak response required timely exchange of information between the outbreak response coordination unit (in Nairobi) and local staff located in multiple locations inside the country. The need to track and timely respond to information requests, to satisfy the information/data needs of polio partners and to track key outbreak response performance indicators dictated the need to urgently set up an online dashboard. The Somalia Polio Room dashboard provided a graphical display of the polio outbreak data to track progress and inform decision making. The system was designed using free and open sources components and seamlessly integrated existing polio surveillance data for real time monitoring of key outbreak response performance indicators. In this article, we describe the design and operation of an electronic dashboard for disease surveillance in an outbreak situation and used the lessons learned to propose key design considerations and functional requirements for online electronic dashboards for disease outbreak response.

Faster Detection of Poliomyelitis Outbreaks to Support Polio Eradication.

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Blake, Isobel M; Chenoweth, Paul; Okayasu, Hiro; Donnelly, Christl A; Aylward, R Bruce; Grassly, Nicholas C

2016-03-01

As the global eradication of poliomyelitis approaches the final stages, prompt detection of new outbreaks is critical to enable a fast and effective outbreak response. Surveillance relies on reporting of acute flaccid paralysis (AFP) cases and laboratory confirmation through isolation of poliovirus from stool. However, delayed sample collection and testing can delay outbreak detection. We investigated whether weekly testing for clusters of AFP by location and time, using the Kulldorff scan statistic, could provide an early warning for outbreaks in 20 countries. A mixed-effects regression model was used to predict background rates of nonpolio AFP at the district level. In Tajikistan and Congo, testing for AFP clusters would have resulted in an outbreak warning 39 and 11 days, respectively, before official confirmation of large outbreaks. This method has relatively high specificity and could be integrated into the current polio information system to support rapid outbreak response activities.

Outbreaks Associated with Treated Recreational Water - United States, 2000-2014.

Science.gov (United States)

Hlavsa, Michele C; Cikesh, Bryanna L; Roberts, Virginia A; Kahler, Amy M; Vigar, Marissa; Hilborn, Elizabeth D; Wade, Timothy J; Roellig, Dawn M; Murphy, Jennifer L; Xiao, Lihua; Yates, Kirsten M; Kunz, Jasen M; Arduino, Matthew J; Reddy, Sujan C; Fullerton, Kathleen E; Cooley, Laura A; Beach, Michael J; Hill, Vincent R; Yoder, Jonathan S

2018-05-18

Outbreaks associated with exposure to treated recreational water can be caused by pathogens or chemicals in venues such as pools, hot tubs/spas, and interactive water play venues (i.e., water playgrounds). During 2000-2014, public health officials from 46 states and Puerto Rico reported 493 outbreaks associated with treated recreational water. These outbreaks resulted in at least 27,219 cases and eight deaths. Among the 363 outbreaks with a confirmed infectious etiology, 212 (58%) were caused by Cryptosporidium (which causes predominantly gastrointestinal illness), 57 (16%) by Legionella (which causes Legionnaires' disease, a severe pneumonia, and Pontiac fever, a milder illness with flu-like symptoms), and 47 (13%) by Pseudomonas (which causes folliculitis ["hot tub rash"] and otitis externa ["swimmers' ear"]). Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks. Overall, the outbreaks had a bimodal temporal distribution: 275 (56%) outbreaks started during June-August and 46 (9%) in March. Assessment of trends in the annual counts of outbreaks caused by Cryptosporidium, Legionella, or Pseudomonas indicate mixed progress in preventing transmission. Pathogens able to evade chlorine inactivation have become leading outbreak etiologies. The consequent outbreak and case counts and mortality underscore the utility of CDC's Model Aquatic Health Code (https://www.cdc.gov/mahc) to prevent outbreaks associated with treated recreational water.

[Waterborne diseases outbreaks in the Czech Republic, 1995-2005].

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Kozísek, F; Jeligová, H; Dvoráková, A

2009-08-01

Despite considerable advances in drinking water safety assurance and adherence to the public health standards, waterborne diaseases outbreaks have still been observed even in industrialized countries. The study objective was to map such outbreaks in the Czech Republic in 1995-2005. In this study, an outbreak is the occurrence of more cases of disease than normally expected within a specific place over a given period of time and a waterborne disease is a disease where water is the vehicle or source of infection. The data on waterborne outbreaks was obtained from the EPIDAT database (national infectious diseases reporting system) information provided by epidemiologists of all regional public health authorities and the National Reference Laboratory for Legionella. In 1995 - 2005, 33 outbreaks with water indicated as the route of transmission were recorded in the Czech Republic. The leading cause was unsafe drinking water (27 outbreaks), mainly from wells (19 outbreaks); nevertheless, the most serious consequences were observed in two outbreaks caused by microbiologically contaminated hot water. Other sources of waterborne infection were mineral water springs, a swimming pool and a brook. The total of reported cases of waterborne diseases was 1655, 356 hospitalisations and ten deaths due to legionellosis were recorded. The highest number of outbreaks (7) as well as the highest number of cases (841) were reported in 1997. Comparison of two five-year periods, i.e. 1996-2000 and 2001-2005, showed a nearly one third decrease in the total of outbreaks and a half reduction in the total of cases in the latter. In view of the limited length of monitoring, it is not possible to say with certainty whether it is a random distribution or an actual trend. Almost two thirds of cases were diagnosed as acute gastroenteritis of probable infectious origin and other frequent waterborne diseases were viral hepatitis A and bacillary dysentery. When analyzing the described outbreaks, it

Effect of Oxygen on Verbenone Conversion From cis-Verbenol by Gut Facultative Anaerobes of Dendroctonus valens

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Qingjie Cao

2018-03-01

Full Text Available Since its introduction from North America, Dendroctonus valens LeConte has become a destructive forest pest in China. Although gut aerobic bacteria have been investigated and some are implicated in beetle pheromone production, little is known about the abundance and significance of facultative anaerobic bacteria in beetle gut, especially with regards to effects of oxygen on their role in pheromone production. In this study, we isolated and identified gut bacteria of D. valens adults in an anaerobic environment, and further compared their ability to convert cis-verbenol into verbenone (a multi-functional pheromone of D. valens under different O2 concentrations. Pantoea conspicua, Enterobacter xiangfangensis, Staphylococcus warneri were the most frequently isolated species among the total of 10 species identified from beetle gut in anaerobic conditions. Among all isolated species, nine were capable of cis-verbenol to verbenone conversion, and the conversion efficiency increased with increased oxygen concentration. This O2-mediated conversion of cis-verbenol to verbenone suggests that gut facultative anaerobes of D. valens might play an important role in the frass, where there is higher exposure to oxygen, hence the higher verbenone production. This claim is further supported by distinctly differential oxygen concentrations between gut and frass of D. valens females.

Large Outbreak Caused by Methicillin Resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital – From Outbreak Control to Outbreak Prevention

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Grönthal, Thomas; Moodley, Arshnee; Nykäsenoja, Suvi; Junnila, Jouni; Guardabassi, Luca; Thomson, Katariina; Rantala, Merja

2014-01-01

Introduction The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 – January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Methods Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Results Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3–17.0, P = 0.0003), antimicrobial treatment (OR = 3.8, CI95% 1.0–13.9, P = 0.0442), cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1–1.6, P = 0.0007) or in the surgery ward (OR = 1.1, CI95% 1.0–1.3, P = 0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Conclusion Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring

Molecular Diagnostic Analysis of Outbreak Scenarios

Science.gov (United States)

Morsink, M. C.; Dekter, H. E.; Dirks-Mulder, A.; van Leeuwen, W. B.

2012-01-01

In the current laboratory assignment, technical aspects of the polymerase chain reaction (PCR) are integrated in the context of six different bacterial outbreak scenarios. The "Enterobacterial Repetitive Intergenic Consensus Sequence" (ERIC) PCR was used to analyze different outbreak scenarios. First, groups of 2-4 students determined optimal…

Outbreak of ocular toxoplasmosis in Coimbatore, India

Directory of Open Access Journals (Sweden)

Palanisamy Manikandan

2006-01-01

Full Text Available Toxoplasma gondii is a protozoan parasite that infects up to a third of the world′s population. Infection is mainly acquired by ingestion of food that is contaminated with oocysts. We report an outbreak of ocular toxoplasmosis, which is an acute acquired type rather than reactivation of congenital toxoplasmosis. Our preliminary investigation points to municipal water contamination. This outbreak only proves the need of an effective public health system and health education in curtailing any outbreak.

MRSA outbreak at a transplantation unit

Directory of Open Access Journals (Sweden)

RMC Romanelli

Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA infections frequently complicate the post-operative course of transplant recipients, and despite nasal carriage and endemic colonization, MRSA outbreaks are not commonly described. This study reports a case of MRSA outbreak and discusses infection control measures and recommendations for this situation.

Investigating Listeria Outbreaks

Centers for Disease Control (CDC) Podcasts

Dr. Emily Cartwright, Infectious Disease fellow at Emory University and former EIS Officer with CDC’s Division of Foodborne, Waterborne, and Environmental Diseases discusses foodborne Listeria outbreaks.

Mitigating Infectious Disease Outbreaks

Science.gov (United States)

Davey, Victoria

The emergence of new, transmissible infections poses a significant threat to human populations. As the 2009 novel influenza A/H1N1 pandemic and the 2014-2015 Ebola epidemic demonstrate, we have observed the effects of rapid spread of illness in non-immune populations and experienced disturbing uncertainty about future potential for human suffering and societal disruption. Clinical and epidemiologic characteristics of a newly emerged infectious organism are usually gathered in retrospect as the outbreak evolves and affects populations. Knowledge of potential effects of outbreaks and epidemics and most importantly, mitigation at community, regional, national and global levels is needed to inform policy that will prepare and protect people. Study of possible outcomes of evolving epidemics and application of mitigation strategies is not possible in observational or experimental research designs, but computational modeling allows conduct of `virtual' experiments. Results of well-designed computer simulations can aid in the selection and implementation of strategies that limit illness and death, and maintain systems of healthcare and other critical resources that are vital to public protection. Mitigating Infectious Disease Outbreaks.

Outbreak or Epidemic? How Obama's Language Choice Transformed the Ebola Outbreak Into an Epidemic.

Science.gov (United States)

Gesser-Edelsburg, Anat; Shir-Raz, Yaffa; Bar-Lev, Oshrat Sassoni; James, James J; Green, Manfred S

2016-08-01

Our aim was to examine in what terms leading newspapers' online sites described the current Ebola crisis. We employed a quantitative content analysis of terms attributed to Ebola. We found and analyzed 582 articles published between March 23 and September 30, 2014, on the online websites of 3 newspapers: The New York Times, Daily Mail, and Ynet. Our theoretical framework drew from the fields of health communication and emerging infectious disease communication, including such concepts as framing media literacy, risk signatures, and mental models. We found that outbreak and epidemic were used interchangeably in the articles. From September 16, 2014, onward, epidemic predominated, corresponding to when President Barack Obama explicitly referred to Ebola as an epidemic. Prior to Obama's speech, 86.8% of the articles (323) used the term outbreak and only 8.6% (32) used the term epidemic. Subsequently, both terms were used almost the same amount: 53.8% of the articles (113) used the term outbreak and 53.3% (112) used the term epidemic. Effective communication is crucial during public health emergencies such as Ebola, because language framing affects the decision-making process of social judgments and actions. The choice of one term (outbreak) over another (epidemic) can create different conceptualizations of the disease, thereby influencing the risk signature. (Disaster Med Public Health Preparedness. 2016;10:669-673).

Infection control during filoviral hemorrhagic fever outbreaks

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N Raabe Vanessa

2012-01-01

Full Text Available Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website.

A Classification System for Hospital-Based Infection Outbreaks

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Paul S. Ganney

2010-01-01

Full Text Available Outbreaks of infection within semi-closed environments such as hospitals, whether inherent in the environment (such as Clostridium difficile (C.Diff or Methicillinresistant Staphylococcus aureus (MRSA or imported from the wider community (such as Norwalk-like viruses (NLVs, are difficult to manage. As part of our work on modelling such outbreaks, we have developed a classification system to describe the impact of a particular outbreak upon an organization. This classification system may then be used in comparing appropriate computer models to real outbreaks, as well as in comparing different real outbreaks in, for example, the comparison of differing management and containment techniques and strategies. Data from NLV outbreaks in the Hull and East Yorkshire Hospitals NHS Trust (the Trust over several previous years are analysed and classified, both for infection within staff (where the end of infection date may not be known and within patients (where it generally is known. A classification system consisting of seven elements is described, along with a goodness-of-fit method for comparing a new classification to previously known ones, for use in evaluating a simulation against history and thereby determining how ‘realistic’ (or otherwise it is.

A classification system for hospital-based infection outbreaks.

Science.gov (United States)

Ganney, Paul S; Madeo, Maurice; Phillips, Roger

2010-12-01

Outbreaks of infection within semi-closed environments such as hospitals, whether inherent in the environment (such as Clostridium difficile (C.Diff) or Methicillin-resistant Staphylococcus aureus (MRSA) or imported from the wider community (such as Norwalk-like viruses (NLVs)), are difficult to manage. As part of our work on modelling such outbreaks, we have developed a classification system to describe the impact of a particular outbreak upon an organization. This classification system may then be used in comparing appropriate computer models to real outbreaks, as well as in comparing different real outbreaks in, for example, the comparison of differing management and containment techniques and strategies. Data from NLV outbreaks in the Hull and East Yorkshire Hospitals NHS Trust (the Trust) over several previous years are analysed and classified, both for infection within staff (where the end of infection date may not be known) and within patients (where it generally is known). A classification system consisting of seven elements is described, along with a goodness-of-fit method for comparing a new classification to previously known ones, for use in evaluating a simulation against history and thereby determining how 'realistic' (or otherwise) it is.

Measles & rubella outbreaks in Maharashtra State, India

Science.gov (United States)

Vaidya, Sunil R.; Kamble, Madhukar B.; Chowdhury, Deepika T.; Kumbhar, Neelakshi S.

2016-01-01

Background & objectives: Under the outbreak-based measles surveillance in Maharashtra State the National Institute of Virology at Pune receives 3-5 serum samples from each outbreak and samples from the local hospitals in Pune for laboratory diagnosis. This report describes one year data on the measles and rubella serology, virus isolation and genotyping. Methods: Maharashtra State Health Agencies investigated 98 suspected outbreaks between January-December 2013 in the 20 districts. Altogether, 491 serum samples were received from 20 districts and 126 suspected cases from local hospitals. Samples were tested for the measles and rubella IgM antibodies by commercial enzyme immunoassay (EIA). To understand the diagnostic utility, a subset of serum samples (n=53) was tested by measles focus reduction neutralization test (FRNT). Further, 37 throat swabs and 32 urine specimens were tested by measles reverse transcription (RT)-PCR and positive products were sequenced. Virus isolation was performed in Vero hSLAM cells. Results: Of the 98 suspected measles outbreaks, 61 were confirmed as measles, 12 as rubella and 21 confirmed as the mixed outbreaks. Four outbreaks remained unconfirmed. Of the 126 cases from the local hospitals, 91 were confirmed for measles and three for rubella. Overall, 93.6 per cent (383/409) confirmed measles cases were in the age group of 0-15 yr. Measles virus was detected in 18 of 38 specimens obtained from the suspected cases. Sequencing of PCR products revealed circulation of D4 (n=9) and D8 (n=9) strains. Four measles viruses (three D4 & one D8) were isolated. Interpretation & conclusions: Altogether, 94 measles and rubella outbreaks were confirmed in 2013 in the State of Maharasthra indicating the necessity to increase measles vaccine coverage in the State. PMID:27121521

Healthcare-associated outbreaks due to Mucorales and other uncommon fungi.

Science.gov (United States)

Davoudi, Setareh; Graviss, Linda S; Kontoyiannis, Dimitrios P

2015-07-01

Healthcare-associated outbreaks of fungal infections, especially with uncommon and emerging fungi, have become more frequent in the past decade. Here, we reviewed the history and definition of healthcare-associated outbreaks of uncommon fungal infections and discussed the principles of investigating, containing and treatment of these outbreaks. In case of these uncommon diseases, occurrence of two or more cases in a short period is considered as an outbreak. Contaminated medical devices and hospital environment are the major sources of these outbreaks. Care must be taken to differentiate a real infection from colonization or contamination. Defining and identifying cases, describing epidemiologic feature of cases, finding and controlling the source of the outbreak, treating patients, and managing asymptomatic exposed patients are main steps for outbreak elimination. These fungal outbreaks are not only difficult to detect but also hard to treat. Early initiation of appropriate antifungal therapy is strongly associated with improved outcomes in infected patients. Choice of antifungal drugs should be made based on spectrum, pharmacodynamic and pharmacokinetic characteristics and adverse effects of available drugs. Combination antifungal therapy and surgical intervention may be also helpful in selected cases. A multidisciplinary approach and close collaboration between all key partners are necessary for successful control of fungal outbreaks. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

[Hospital hygiene - outbreak management of nosocomial infections].

Science.gov (United States)

Kerwat, Klaus; Wulf, Hinnerk

2012-04-01

According to §6, section 3 of the German Protection against Infections Act [Infektionsschutzgesetz (IfSG)] an outbreak is defined as the occurrence in large numbers of nosocomial infections for which an epidemiological relationship is probable or can be assumed. About 2-10% of nosocomial infections in hospitals (about 5% in intensive care wards) occur within the framework of an outbreak. The heaped occurrence of nosocomial infections can be declared according to the prescribed surveillance of nosocomial infections (§23 IfSG) when, in the course of this assessment, a statistically significant increase in the rate of infections becomes apparent. On the other hand, the occurrence of an outbreak can also be recognized through the vigilance of all involved personnel and a general sensibilization towards this subject. The names of patients involved in outbreaks need not be reported to the responsible health authorities. As a consequence of the report the health authorities become involved in the investigation to determine the cause and its elimination, and to provide support and advice. The outbreak management should be oriented on the respective recommendations of the Robert Koch Institute. © Georg Thieme Verlag Stuttgart · New York.

An outbreak of Salmonella gastroenteritis in an urban jail.

Science.gov (United States)

Alcabes, P; O'Sullivan, B; Nadal, E; Mouzon, M

1988-12-01

An outbreak of gastroenteritis in New York City's largest jail involved 145 cases over a two-month period. The outbreak was unusual in that two Salmonella strains (serogroups B and D) were involved. Management of the outbreak involved screening kitchen workers by culture of stool samples, and education regarding personal hygiene. Obstacles to investigation and management of the outbreak arose out of the special nature of the jail environment; these included jurisdictional problems and high turnover of the inmate population.

A review of critical care nursing and disease outbreak preparedness.

Science.gov (United States)

Makamure, Miranda; Makamure, Muriel; Mendiola, Williane; Renteria, Daisy; Repp, Melissa; Willden, Azshwee

2013-01-01

The impact of disease outbreaks continues to increase globally. As frontline staff, critical care nurses (CCNs) are more likely to be confronted with the need to care for affected patients. With different pathological diseases emerging, CCNs play an integral role in disease outbreaks. The advanced skill set of CCNs is pivotal in the management and care of patients during an outbreak. Lack of planning and preparation before disease outbreaks leads to detrimental patient outcomes. Panic, chaos, and fear for personal safety cause stress and anxiety for unprepared nurses. However, this problem can be resolved. Comprehensive planning, training, and education can better prepare intensive care unit nurses for disease outbreaks. This article reviews some of the current literature on intensive care unit nurse preparedness for disease outbreaks in the United States. This article also offers strategies that may be used to better prepare CCNs for disease outbreaks.

Biology and outbreaks of Microdiprion pallipes (Hymenoptera; Diprionidae) in Sweden

Energy Technology Data Exchange (ETDEWEB)

Olofsson, E. (Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Dept. of Entomology)

1994-01-01

During outbreaks, Microdiprion pallipes (Fall.) is the most destructive of the pine sawflies in Sweden. Its distribution includes most provinces, but damaging outbreaks have until recently occurred only in two inland areas in northern Sweden. These areas are characterised by high elevation, a harsh climate, and slow tree growth. The four recorded outbreak periods showed a 10 year periodicity. Outside these areas, a lesser outbreak occurred in 1988 to 1990, on the east coast (province of Uppland). Outbreak patterns, life history variation, and mortality factors were studied. Factors that may explain the distribution of outbreaks and the population patterns were identified.Experimental and observational evidence on the potential of various factors to influence fecundity, dispersal, and survival was evaluated. In the outbreak areas, there were few major population factors. Parasitism by Rhorus substitutor (Thunb.) was the largest cause of larval mortality and the only important density-dependent mortality factor. The different diapause strategies of M. pallipes and R. substitutor may contribute to stabilize this system. Different flight periods of the host and the parasitoid may explain a possible correlation between weather and outbreaks. Elsewhere in Sweden, where low population densities prevail, there may be similarities in population processes between M. pallipes and the other widely distributed diprionids with solitary larvae, which never have attained outbreak densities in Sweden. Interactions with other diprionids through shared natural enemies may be an important population process and may influence the distribution of outbreaks. 37 refs, 4 figs, 11 tabs

Management of Nosocomial Scabies, an Outbreak of Occupational Disease

NARCIS (Netherlands)

Jungbauer, Frank H. W.; Veenstra-Kyuchukova, Yanka K.; Koeze, Jacqueline; KruijtSpanjer, Martijn R.; Kardaun, Sylvia H.

Background The optimal approach to managing institutional scabies outbreaks has yet to be defined. We report on outbreak managements are needed. Methods We report on a large outbreak of scabies in three acute care wards in a tertiary university teaching hospital in the Netherlands. Results The

Morphology of the Male Reproductive System and Spermiogenesis of Dendroctonus armandi Tsai and Li (Coleoptera: Curculionidae: Scolytinae).

Science.gov (United States)

Wu, Yi-Fei; Wei, Lu-Sha; Anthony Torres, Mark; Zhang, Xu; Wu, Shao-Ping; Chen, Hui

2017-01-01

Studying the reproductive attributes of pests is central to understanding their life cycle history and in crafting management strategies to regulate, if not bring down, their population below threshold levels. In this article, the morphology of the male reproductive tract, topology of the spermatozoa, and salient features of spermiogenesis in the Chinese white pine beetle, Dendroctonus armandi Tsai and Li was studied to provide baseline information for further pest management studies. Results showed that male reproductive tract of this species differs from those documented in other Coleopterans by having 20 testicular tubules in each testis and the presence of two types of accessory glands. The spermatozoon is seen having peculiar characteristics such as an "h"-shaped acrosomal vesicle with a "puff"-like expansion, one centriole, one large spongy body, and two accessory bodies. Despite with some morphological differences of the male reproductive organ, spermatogenesis in this organism is similar to other Coleopterans. Overall, detailed studies regarding the components of the primary male reproductive organ of this beetle species would expand the knowledge on the less-understood biology of Coleopteran pests and would help in designing regulatory measures to conserve endemic and indigenous pine trees in China. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America.

Early outbreak detection by linking health advice line calls to water distribution areas retrospectively demonstrated in a large waterborne outbreak of cryptosporidiosis in Sweden

Directory of Open Access Journals (Sweden)

Pär Bjelkmar

2017-04-01

Full Text Available Abstract Background In the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible source(s and the potential for earlier detection using calls to a health advice line. Methods The investigation included two epidemiological questionnaires and microbial analysis of samples from patients, water and other environmental sources. In addition, a retrospective study based on phone calls to a health advice line was performed by comparing patterns of phone calls between different water distribution areas. Results Our analyses showed that approximately 18,500 individuals were affected by a waterborne outbreak of cryptosporidiosis in Skellefteå in 2011. This makes it the second largest outbreak of cryptosporidiosis in Europe to date. Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and sewage samples, but not in raw water or in drinking water, and the initial contamination source could not be determined. The outbreak went unnoticed to authorities for several months. The analysis of the calls to the health advice line provides strong indications early in the outbreak that it was linked to a particular water treatment plant. Conclusions We conclude that an earlier detection of the outbreak by linking calls to a health advice line to water distribution areas could have limited the outbreak substantially.

Control Measures Used during Lymphogranuloma Venereum Outbreak, Europe

Science.gov (United States)

Hulscher, Marlies E.J.L.; Vos, Dieuwke; van de Laar, Marita J.W.; Fenton, Kevin A.; van Steenbergen, Jim E.; van der Meer, Jos W.M.; Grol, Richard P.T.M.

2008-01-01

To assess the response to the reemergence of lymphogranuloma venereum, we conducted a cross-sectional survey by administering a structured questionnaire to representatives from 26 European countries. Responses were received from 18 countries. The ability to respond quickly and the measures used for outbreak detection and control varied. Evidence-based criteria were not consistently used to develop recommendations. We did not develop criteria to determine the effectiveness of the recommendations. The degree of preparedness for an unexpected outbreak, as well as the ability of countries to respond quickly to alerts, varied, which indicates weaknesses in the ability to control an outbreak. More guidance is needed to implement and evaluate control measures used during international outbreaks. PMID:18394274

Surveillance and Outbreak Response Management System (SORMAS) to support the control of the Ebola virus disease outbreak in West Africa.

Science.gov (United States)

Fähnrich, C; Denecke, K; Adeoye, O O; Benzler, J; Claus, H; Kirchner, G; Mall, S; Richter, R; Schapranow, M P; Schwarz, N; Tom-Aba, D; Uflacker, M; Poggensee, G; Krause, G

2015-03-26

In the context of controlling the current outbreak of Ebola virus disease (EVD), the World Health Organization claimed that 'critical determinant of epidemic size appears to be the speed of implementation of rigorous control measures', i.e. immediate follow-up of contact persons during 21 days after exposure, isolation and treatment of cases, decontamination, and safe burials. We developed the Surveillance and Outbreak Response Management System (SORMAS) to improve efficiency and timeliness of these measures. We used the Design Thinking methodology to systematically analyse experiences from field workers and the Ebola Emergency Operations Centre (EOC) after successful control of the EVD outbreak in Nigeria. We developed a process model with seven personas representing the procedures of EVD outbreak control. The SORMAS system architecture combines latest In-Memory Database (IMDB) technology via SAP HANA (in-memory, relational database management system), enabling interactive data analyses, and established SAP cloud tools, such as SAP Afaria (a mobile device management software). The user interface consists of specific front-ends for smartphones and tablet devices, which are independent from physical configurations. SORMAS allows real-time, bidirectional information exchange between field workers and the EOC, ensures supervision of contact follow-up, automated status reports, and GPS tracking. SORMAS may become a platform for outbreak management and improved routine surveillance of any infectious disease. Furthermore, the SORMAS process model may serve as framework for EVD outbreak modeling.

A Gastroenteritis Outbreak Caused by Noroviruses in Greece

Directory of Open Access Journals (Sweden)

Yiannis Alamanos

2011-08-01

Full Text Available In June 2006, an outbreak alert regarding cases of acute gastroenteritis in a region in North Eastern Greece (population 100,882 inhabitants, triggered investigations to guide control measures. The outbreak started the first days of June, and peaked in July. A descriptive epidemiological study, a virological characterization of the viral agent identified from cases as well as a phylogenetic analysis was performed. From June 5 to September 3, 2006 (weeks 23–44, 1,640 cases of gastroenteritis (45.2% male and 54.8% female, aged 3 months to 89 years were reported. The overall attack rate for the period was 16.3 cases/1,000 inhabitants. About 57% of cases observed were under the age of 15 years. Αnalysis of faecal samples identified Norovirus GII strains. Fifteen different Norovirus GII strains were recorded, presenting a homology of 94.8% (86–97% to GII strains obtained from GenBank. The long duration of the outbreak suggests an important role of person-to-person transmission, while the emergence of the outbreak was possibly due to contaminated potable water, although no viruses were detected in any tested water samples. This outbreak underscores the need for a national surveillance system for acute non-bacterial gastroenteritis outbreaks.

Planning for smallpox outbreaks

Science.gov (United States)

Ferguson, Neil M.; Keeling, Matt J.; John Edmunds, W.; Gani, Raymond; Grenfell, Bryan T.; Anderson, Roy M.; Leach, Steve

2003-10-01

Mathematical models of viral transmission and control are important tools for assessing the threat posed by deliberate release of the smallpox virus and the best means of containing an outbreak. Models must balance biological realism against limitations of knowledge, and uncertainties need to be accurately communicated to policy-makers. Smallpox poses the particular challenge that key biological, social and spatial factors affecting disease spread in contemporary populations must be elucidated largely from historical studies undertaken before disease eradication in 1979. We review the use of models in smallpox planning within the broader epidemiological context set by recent outbreaks of both novel and re-emerging pathogens.

Characteristics of pertussis outbreaks in Catalonia, Spain, 1997 to 2010.

Science.gov (United States)

Crespo, Inma; Broner, Sonia; Soldevila, Núria; Martínez, Ana; Godoy, Pere; Sala-Farré, Maria-Rosa; Company, Maria; Rius, Cristina; Domínguez, Angela; Group Of Catalonia, The Pertussis Working

2015-01-01

In Catalonia, pertussis outbreaks must be reported to the Department of Health. This study analyzed pertussis outbreaks between 1997 and 2010 in general and according to the characteristics of the index cases. The outbreak rate, hospitalization rate and incidence of associated cases and their 95%CI were calculated. Index cases were classified in two groups according to age (<15 years and ≥15 years) and the vaccine type received: whole cell vaccine (DTwP) or acellular vaccine (DTaP). During the study period, 230 outbreaks were reported. The outbreak rate was 2.43 × 10(-6) persons-year, and outbreaks ranged from 2 to 32 cases, with a median duration of 18 days. There were 771 associated cases, with an incidence rate of 0.8 × 10(-5) persons-year.   After classifying outbreaks according to the age of the index case, 126 outbreaks (1.3 × 10(-6) persons-year) had an index case aged <15 y and 87 (0.87 × 10(-6) person-year) had an index case aged ≥15 y (RR = 1.44, 95%CI 1.10-1.90; P = 0.007). Between 2003 and 2010, after the introduction of the acellular vaccine, the index case was vaccinated with DTwP vaccine in 25 outbreaks (0.43 × 10(-6) persons-year) and with DTaP vaccine in 32 outbreaks (0.55 × 10(-6) person-year) (RR = 0.78, 95%CI 0.46-1.31; P = 0.35). Of cases, 37.2% were correctly vaccinated, suggesting waning immunity of pertussis vaccine protection and endogenous circulation of pertussis. A greater number of outbreaks had an index case aged <15 y. No changes in the disease incidence, associated cases and hospitalization rate were observed after the introduction of DTaP.

Typing of Salmonella enterica serovar Saintpaul: an outbreak investigation

DEFF Research Database (Denmark)

Baggesen, Dorte Lau; Wegener, Henrik Caspar; Christensen, J.P.

1996-01-01

factor, antibiogram typing, plasmid profiling, ribotyping and pulsed field gel electrophoresis, in order to identify the most probable source of infection. After typing, the source of the investigated outbreak remains obscure because so far no isolates with traits of the outbreak strain have been...... explanation for the failure to find isolates with traits of the outbreak strain could be the presence of a third, but so far unidentified, source. The present investigation illustrates the necessity of using more than one epidemiological typing method for outbreak investigation. This is especially important...

Outbreaks and Investigations

Science.gov (United States)

... Who Gets Fungal Infections? People living with HIV/AIDS Organ Transplant Patients Cancer Patients Hospitalized Patients Stem Cell Transplant Patients Medications that Weaken Your Immune System Outbreaks Rhizopus Investigation CDC at Work Global Fungal Diseases Cryptococcal Meningitis ...

Cholera outbreak in districts around Lake Chilwa, Malawi: Lessons ...

African Journals Online (AJOL)

Cholera is endemic in Malawi with seasonal outbreaks during the wet season. People living around Lake Chilwa rely on the lake for their water supply. From May 2009 to May 2010, a cholera outbreak occurred in fishing communities around Lake Chilwa. This paper describes the outbreak response and lessons learned for ...

[Norovirus outbreaks in hospitals and nursing homes in Catalonia, Spain].

Science.gov (United States)

Godoy, Pere; Domínguez, Angela; Alvarez, Josep; Camps, Neus; Barrabeig, Irene; Bartolomé, Rosa; Sala, María Rosa; Ferre, Dolors; Pañella, Helena; Torres, Joan; Minguell, Sofía; Alsedà, Miquel; Pumares, Analía

2009-01-01

The low infectious dose and multiple transmission routes favour the appearance of norovirus outbreaks. The objective of this study was to compare the incidence of norovirus outbreaks in hospitals and nursing homes in Catalonia. A descriptive study of norovirus outbreaks between 15/10/2004 and 30/10/2005 was carried out. An epidemiological survey was completed for each outbreak. Norovirus in clinical samples was determined by PCR techniques. The incidence in each centre and the annual incidence of outbreaks by centre were calculated. Differences were calculated using the chi-square test and the Student's t test, taking a p value of > 0.05 as significant. Seventeen outbreaks (6 in hospitals and 11 in nursing homes) were detected. The global attack rate was 33.4% (652/1951) and was slightly higher in nursing homes (35.2%) than in hospitals (31.4%). A total of 94.1% (16/17) of outbreaks were caused by person-to-person transmission and only 5.9% (1/17) by foods. The mean number of days between the first and last case was 11.4 (SD = 6.9). The mean duration of symptoms was 2.39 days (SD=1.6), and was higher hospitals, 2.63 (SD=1.7), than in nursing homes, 1.97 (SD=1.7) (p < 0.0001). Norovirus is responsible for a large number of outbreaks due to person-to-person transmission. Control should be standardized to reduce the number and duration of outbreaks.

Nanopore Sequencing as a Rapidly Deployable Ebola Outbreak Tool.

Science.gov (United States)

Hoenen, Thomas; Groseth, Allison; Rosenke, Kyle; Fischer, Robert J; Hoenen, Andreas; Judson, Seth D; Martellaro, Cynthia; Falzarano, Darryl; Marzi, Andrea; Squires, R Burke; Wollenberg, Kurt R; de Wit, Emmie; Prescott, Joseph; Safronetz, David; van Doremalen, Neeltje; Bushmaker, Trenton; Feldmann, Friederike; McNally, Kristin; Bolay, Fatorma K; Fields, Barry; Sealy, Tara; Rayfield, Mark; Nichol, Stuart T; Zoon, Kathryn C; Massaquoi, Moses; Munster, Vincent J; Feldmann, Heinz

2016-02-01

Rapid sequencing of RNA/DNA from pathogen samples obtained during disease outbreaks provides critical scientific and public health information. However, challenges exist for exporting samples to laboratories or establishing conventional sequencers in remote outbreak regions. We successfully used a novel, pocket-sized nanopore sequencer at a field diagnostic laboratory in Liberia during the current Ebola virus outbreak.

Management of Animal Botulism Outbreaks: From Clinical Suspicion to Practical Countermeasures to Prevent or Minimize Outbreaks

DEFF Research Database (Denmark)

Anniballi, Fabrizio; Fiore, Alfonsina; Löfström, Charlotta

2013-01-01

and economic concern because of its high mortality rate. Moreover, meat or other products from affected animals entering the food chain may result in a public health problem. To this end, early diagnosis is crucial to define and apply appropriate veterinary public health measures. Clinical diagnosis is based...... outbreaks. In this article we outline all phases of management of animal botulism outbreaks occurring in wet wild birds, poultry, cattle, horses, and fur farm animals....

Tuberculosis Outbreak Investigations in the U.S.

Centers for Disease Control (CDC) Podcasts

2011-02-22

In this podcast, Dr Kiren Mitruka, medical officer with CDC's Tuberculosis Outbreak Investigations team, discusses tuberculosis outbreak investigations in the U.S. from 2002-2008.  Created: 2/22/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 3/22/2011.

Cost of dengue outbreaks: literature review and country case studies.

Science.gov (United States)

Stahl, Hans-Christian; Butenschoen, Vicki Marie; Tran, Hien Tinh; Gozzer, Ernesto; Skewes, Ronald; Mahendradhata, Yodi; Runge-Ranzinger, Silvia; Kroeger, Axel; Farlow, Andrew

2013-11-06

Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save--through early response activities--resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems.The country case studies--conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the different cost components (vector control

Grasshopper species composition shifts following a severe rangeland grasshopper outbreak

Science.gov (United States)

Little is known about how grasshopper species abundances shift during and following severe outbreaks, as sampling efforts usually end when outbreaks subside. Grasshopper densities, species composition and vegetation have infrequently been sampled during and after a severe outbreak in the western U.S...

The Methanol Poisoning Outbreaks in Libya 2013 and Kenya 2014.

Science.gov (United States)

Rostrup, Morten; Edwards, Jeffrey K; Abukalish, Mohamed; Ezzabi, Masoud; Some, David; Ritter, Helga; Menge, Tom; Abdelrahman, Ahmed; Rootwelt, Rebecca; Janssens, Bart; Lind, Kyrre; Paasma, Raido; Hovda, Knut Erik

2016-01-01

Outbreaks of methanol poisoning occur frequently on a global basis, affecting poor and vulnerable populations. Knowledge regarding methanol is limited, likely many cases and even outbreaks go unnoticed, with patients dying unnecessarily. We describe findings from the first three large outbreaks of methanol poisoning where Médecins Sans Frontières (MSF) responded, and evaluate the benefits of a possible future collaboration between local health authorities, a Non-Governmental Organisation and international expertise. Retrospective study of three major methanol outbreaks in Libya (2013) and Kenya (May and July 2014). Data were collected from MSF field personnel, local health personnel, hospital files, and media reports. In Tripoli, Libya, over 1,000 patients were poisoned with a reported case fatality rate of 10% (101/1,066). In Kenya, two outbreaks resulted in approximately 341 and 126 patients, with case fatality rates of 29% (100/341) and 21% (26/126), respectively. MSF launched an emergency team with international experts, medications and equipment, however, the outbreaks were resolving by the time of arrival. Recognition of an outbreak of methanol poisoning and diagnosis seem to be the most challenging tasks, with significant delay from time of first presentations to public health warnings being issued. In spite of the rapid response from an emergency team, the outbreaks were nearly concluded by the time of arrival. A major impact on the outcome was not seen, but large educational trainings were conducted to increase awareness and knowledge about methanol poisoning. Based on this training, MSF was able to send a local emergency team during the second outbreak, supporting that such an approach could improve outcomes. Basic training, simplified treatment protocols, point-of-care diagnostic tools, and early support when needed, are likely the most important components to impact the consequences of methanol poisoning outbreaks in these challenging contexts.

Estimated Cost to a Restaurant of a Foodborne Illness Outbreak.

Science.gov (United States)

Bartsch, Sarah M; Asti, Lindsey; Nyathi, Sindiso; Spiker, Marie L; Lee, Bruce Y

Although outbreaks of restaurant-associated foodborne illness occur periodically and make the news, a restaurant may not be aware of the cost of an outbreak. We estimated this cost under varying circumstances. We developed a computational simulation model; scenarios varied outbreak size (5 to 250 people affected), pathogen (n = 15), type of dining establishment (fast food, fast casual, casual dining, and fine dining), lost revenue (ie, meals lost per illness), cost of lawsuits and legal fees, fines, and insurance premium increases. We estimated that the cost of a single foodborne illness outbreak ranged from $3968 to $1.9 million for a fast-food restaurant, $6330 to $2.1 million for a fast-casual restaurant, $8030 to $2.2 million for a casual-dining restaurant, and $8273 to $2.6 million for a fine-dining restaurant, varying from a 5-person outbreak, with no lost revenue, lawsuits, legal fees, or fines, to a 250-person outbreak, with high lost revenue (100 meals lost per illness), and a high amount of lawsuits and legal fees ($1 656 569) and fines ($100 000). This cost amounts to 10% to 5790% of a restaurant's annual marketing costs and 0.3% to 101% of annual profits and revenue. The biggest cost drivers were lawsuits and legal fees, outbreak size, and lost revenue. Pathogen type affected the cost by a maximum of $337 000, the difference between a Bacillus cereus outbreak (least costly) and a listeria outbreak (most costly). The cost of a single foodborne illness outbreak to a restaurant can be substantial and outweigh the typical costs of prevention and control measures. Our study can help decision makers determine investment and motivate research for infection-control measures in restaurant settings.

Hepatitis A outbreaks in the vaccination era in Catalonia, Spain.

Science.gov (United States)

Martínez, Ana; Broner, Sonia; Torner, Nuria; Godoy, Pere; Batalla, Joan; Alvarez, Josep; Barrabeig, Irene; Camps, Neus; Carmona, Gloria; Minguell, Sofía; Sala, Rosa; Caylà, Joan; Domínguez, Angela

2011-01-01

Hepatitis A outbreaks have a major impact on public health services and involve case investigation and intervention measures to susceptible contacts. At the end of 1998 a universal vaccination program with a combined hepatitis A+B vaccine was started in Catalonia (Spain) in 12-years-old preadolescents. The objective of this study was to compare the characteristics of hepatitis A outbreaks in the periods before and after the introduction of the preadolescent vaccination program and to estimate the preventable fraction of cases associated to outbreaks. The incidence rates of outbreaks, cases and hospitalization associated with each outbreak were calculated. Two periods were considered: before (1991-1998) and after (2000-2007) the introduction of mass vaccination. The preventable fraction and 95% confidence intervals (CI) of cases associated with outbreaks was calculated. The rate of associated cases with outbreaks was higher in the period before the vaccination program than in the post vaccination period (1.53 per 100,000 person-year vs 1.12 ; pcases associated to outbreaks was 19.6%(95%CI 6.7-32.5) in the 0-4 years group and 16.7% (95% CI 6.0-27.5) in the 5-14 years group, but the highest figure (38.6%; 95%CI 21.3-55.9) was observed in the 15-24 years age group. The estimated proportion of cases associated with outbreaks that would theoretically have been prevented with the vaccination program suggests that substantial benefits have been obtained in Catalonia in people aged less than 25 years.

Population densities and tree diameter effects associated with verbenone treatments to reduce mountain pine beetle-caused mortality of lodgepole pine.

Science.gov (United States)

Progar, R A; Blackford, D C; Cluck, D R; Costello, S; Dunning, L B; Eager, T; Jorgensen, C L; Munson, A S; Steed, B; Rinella, M J

2013-02-01

Mountain pine beetle, Dendroctonus ponderosae Hopkins (Coleoptera: Curculionidae: Scolytinae), is among the primary causes of mature lodgepole pine, Pinus contorta variety latifolia mortality. Verbenone is the only antiaggregant semiochemical commercially available for reducing mountain pine beetle infestation of lodgepole pine. The success of verbenone treatments has varied greatly in previous studies because of differences in study duration, beetle population size, tree size, or other factors. To determine the ability of verbenone to protect lodgepole pine over long-term mountain pine beetle outbreaks, we applied verbenone treatments annually for 3 to 7 yr at five western United States sites. At one site, an outbreak did not develop; at two sites, verbenone reduced lodgepole pine mortality in medium and large diameter at breast height trees, and at the remaining two sites verbenone was ineffective at reducing beetle infestation. Verbenone reduced mountain pine beetle infestation of lodgepole pine trees in treated areas when populations built gradually or when outbreaks in surrounding untreated forests were of moderate severity. Verbenone did not protect trees when mountain pine beetle populations rapidly increase.

Tularaemia outbreaks in Sakarya, Turkey: case-control and environmental studies.

Science.gov (United States)

Meric, M; Sayan, M; Dundar, D; Willke, A

2010-08-01

Tularaemia is an important zoonotic disease that leads to outbreaks. This study aimed to compare the epidemiological characteristics of two tularaemia outbreaks that occurred in the Sakarya region of Turkey, analyse the risk factors for the development of outbreaks and identify Francisella (F.) tularensis in the water samples. Two tularaemia outbreaks occurred in the Kocadongel village in 2005 and 2006. A field investigation and a case-control study with 47 cases and 47 healthy households were performed during the second outbreak. Clinical samples from the patients and filtrated water samples were analysed for F. tularensis via real-time polymerase chain reaction. From the two outbreaks, a total of 58 patients were diagnosed with oropharyngeal tularaemia based on their clinical and serological results. Both outbreaks occurred between the months of January and April, and the number of patients peaked in February. Logistic regression analysis revealed that the consumption of natural spring water was the only significant risk factor for tularaemia infection (odds ratio 3.5, confidence interval 1.23-10.07). F. tularensis was detected in eight clinical samples and in the filtrated natural spring water. This study is the first report of tularaemia from this region. The results show that both tularaemia outbreaks were related to the consumption of untreated natural spring water. To prevent waterborne tularaemia, community water supplies should be treated and checked periodically.

Molecular Investigation of Tularemia Outbreaks, Spain, 1997–2008

Science.gov (United States)

Ariza-Miguel, Jaime; Johansson, Anders; Fernández-Natal, María Isabel; Martínez-Nistal, Carmen; Orduña, Antonio; Rodríguez-Ferri, Elías F.; Hernández, Marta

2014-01-01

Tularemia outbreaks occurred in northwestern Spain in 1997–1998 and 2007–2008 and affected >1,000 persons. We assessed isolates involved in these outbreaks by using pulsed-field gel electrophoresis with 2 restriction enzymes and multilocus variable number tandem repeat analysis of 16 genomic loci of Francisella tularensis, the cause of this disease. Isolates were divided into 3 pulsotypes by pulsed-field gel electrophoresis and 8 allelic profiles by multilocus variable number tandem repeat analysis. Isolates obtained from the second tularemia outbreak had the same genotypes as isolates obtained from the first outbreak. Both outbreaks were caused by genotypes of genetic subclade B.Br:FTNF002–00, which is widely distributed in countries in central and western Europe. Thus, reemergence of tularemia in Spain was not caused by the reintroduction of exotic strains, but probably by persistence of local reservoirs of infection. PMID:24750848

A Tale of Two Forests: Simulating Contrasting Lodgepole Pine and Spruce Forest Water and Carbon Fluxes Following Mortality from Bark Beetles

Science.gov (United States)

Ewers, B. E.; Peckham, S. D.; Mackay, D. S.; Pendall, E.; Frank, J. M.; Massman, W. J.; Reed, D. E.; Borkhuu, B.

2014-12-01

In recent decades, bark beetle infestation in western North America has reached epidemic levels. The resulting widespread forest mortality may have profound effects on present and future water and carbon cycling with potential negative consequences to a region that relies on water from montane and subalpine watersheds. We simulated stand-level ecosystem fluxes of water and carbon at two bark beetle-attacked conifer forests in southeast Wyoming, USA. The lower elevation site dominated by lodgepole pine (Pinus contorta) was attacked by mountain pine beetle (Dendroctonus ponderosae) during 2008-2010. The high elevation Engelmann spruce (Picea engelmannii) dominated site was attacked by the spruce beetle (Dendroctonus rufipennis) during roughly the same time period. Both beetle infestations resulted in >60% canopy mortality in the footprint of eddy covariance towers located at each site. However, carbon and water fluxes responses to mortality depended on the forest type. Using data collected at the sites, we scaled simulated plant hydraulic conductivity by either percent canopy mortality or loss of live tree basal area during infestation. We also simulated a case of no beetle attack. At the lodgepole site, the no-beetle model best fit the data and showed no significant change in growing season carbon flux and a 15% decrease in evapotranspiration (ET). However, at the spruce site, the simulation that tracked canopy loss agreed best with observations: carbon flux decreased by 72% and ET decreased by 31%. In the lodgepole stand, simulated soil water content agreed with spatially distributed measurements that were weighted to reflect overall mortality in the tower footprint. Although these two forest ecosystems are only 20 km apart, separated by less than 300m in elevation, and have been impacted by similar mortality agents, the associated changes in carbon and water cycling are significantly different. Beetle effects on hydrologic cycling were greatest at high elevation

Epidemiology of bacterial toxin-mediated foodborne gastroenteritis outbreaks in Australia, 2001 to 2013.

Science.gov (United States)

May, Fiona J; Polkinghorne, Benjamin G; Fearnley, Emily J

2016-12-24

Bacterial toxin-mediated foodborne outbreaks, such as those caused by Clostridium perfringens, Staphylococcus aureus and Bacillus cereus, are an important and preventable cause of morbidity and mortality. Due to the short incubation period and duration of illness, these outbreaks are often under-reported. This is the first study to describe the epidemiology of bacterial toxin-mediated outbreaks in Australia. Using data collected between 2001 and 2013, we identify high risk groups and risk factors to inform prevention measures. Descriptive analyses of confirmed bacterial toxin-mediated outbreaks between 2001 and 2013 were undertaken using data extracted from the OzFoodNet Outbreak Register, a database of all outbreaks of gastrointestinal disease investigated by public health authorities in Australia. A total of 107 laboratory confirmed bacterial toxin-mediated outbreaks were reported between 2001 and 2013, affecting 2,219 people, including 47 hospitalisations and 13 deaths. Twelve deaths occurred in residents of aged care facilities. Clostridium perfringens was the most commonly reported aetiological agent (81 outbreaks, 76%). The most commonly reported food preparation settings were commercial food preparation services (51 outbreaks, 48%) and aged care facilities (42 outbreaks, 39%). Bacterial toxin outbreaks were rarely associated with food preparation in the home (2 outbreaks, 2%). In all outbreaks, the primary factor contributing to the outbreak was inadequate temperature control of the food. Public health efforts aimed at improving storage and handling practices for pre-cooked and re-heated foods, especially in commercial food preparation services and aged care facilities, could help to reduce the magnitude of bacterial toxin outbreaks.

Foodborne Norovirus Outbreaks

Centers for Disease Control (CDC) Podcasts

2012-09-17

Dr. Aron Hall, a CDC epidemiologist specializing in noroviruses, discusses foodborne norovirus outbreaks.  Created: 9/17/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/17/2012.

Outbreak of caliciviruses in the Singapore military, 2015.

Science.gov (United States)

Neo, Freddy Jun Xian; Loh, Jimmy Jin Phang; Ting, Peijun; Yeo, Wei Xin; Gao, Christine Qiu Han; Lee, Vernon Jian Ming; Tan, Boon Huan; Ng, Ching Ging

2017-11-14

From 31 August to 9 September 2015, a total of 150 military personnel at a military institution in Singapore were infected with acute gastroenteritis (AGE) with an attack rate of approximately 3%. This study aimed to determine the epidemiology of the outbreak, investigate its origins, and discuss measures to prevent future occurrences. After the AGE outbreak was declared on 31 August 2015, symptom surveys, hygiene inspections, and the testing of water, food, and stool samples were initiated. We collected 86 stool samples from AGE cases and 58 samples from food-handlers during the course of the outbreak and these stool samples were tested for 8 bacterial pathogens and 2 viral pathogens (i.e., norovirus and sapovirus). We detected Sapovirus (SaV), group I Norovirus (NoV GI) and group II Norovirus (NoV GII) from the stool samples of AGE cases. Further sequence analyses showed that the AGE outbreak in August was caused mainly by three rarely reported calicivirus novel genotypes: NoV GI.7, NoV GII.17 and SaV GII.3. Control measures implemented focused on the escalation of personal and environmental hygiene, which included the separation of affected and unaffected soldiers, enforcement of rigorous hand-washing and hygiene, raising awareness of food and water safety, and disinfection of communal areas with bleach. This study identified both NoV and SaV as the causative agents for an AGE outbreak at a Singapore military camp in August 2015. This study is also the first to report SaV as one of the main causative agents, highlighting the importance of caliciviruses as causative agents of AGE outbreaks in the Singapore military. As there are no commercially available vaccines against caliciviruses, strict personal hygiene and proper disinfection of environmental surfaces remain crucial to prevent calicivirus outbreak and transmission.

Model-specification uncertainty in future forest pest outbreak.

Science.gov (United States)

Boulanger, Yan; Gray, David R; Cooke, Barry J; De Grandpré, Louis

2016-04-01

Climate change will modify forest pest outbreak characteristics, although there are disagreements regarding the specifics of these changes. A large part of this variability may be attributed to model specifications. As a case study, we developed a consensus model predicting spruce budworm (SBW, Choristoneura fumiferana [Clem.]) outbreak duration using two different predictor data sets and six different correlative methods. The model was used to project outbreak duration and the uncertainty associated with using different data sets and correlative methods (=model-specification uncertainty) for 2011-2040, 2041-2070 and 2071-2100, according to three forcing scenarios (RCP 2.6, RCP 4.5 and RCP 8.5). The consensus model showed very high explanatory power and low bias. The model projected a more important northward shift and decrease in outbreak duration under the RCP 8.5 scenario. However, variation in single-model projections increases with time, making future projections highly uncertain. Notably, the magnitude of the shifts in northward expansion, overall outbreak duration and the patterns of outbreaks duration at the southern edge were highly variable according to the predictor data set and correlative method used. We also demonstrated that variation in forcing scenarios contributed only slightly to the uncertainty of model projections compared with the two sources of model-specification uncertainty. Our approach helped to quantify model-specification uncertainty in future forest pest outbreak characteristics. It may contribute to sounder decision-making by acknowledging the limits of the projections and help to identify areas where model-specification uncertainty is high. As such, we further stress that this uncertainty should be strongly considered when making forest management plans, notably by adopting adaptive management strategies so as to reduce future risks. © 2015 Her Majesty the Queen in Right of Canada Global Change Biology © 2015 Published by John

Cost of dengue outbreaks: literature review and country case studies

Science.gov (United States)

2013-01-01

Background Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save – through early response activities – resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Methods Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Results Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems. The country case studies – conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the

Cost-Analysis of Seven Nosocomial Outbreaks in an Academic Hospital.

Science.gov (United States)

Dik, Jan-Willem H; Dinkelacker, Ariane G; Vemer, Pepijn; Lo-Ten-Foe, Jerome R; Lokate, Mariëtte; Sinha, Bhanu; Friedrich, Alex W; Postma, Maarten J

2016-01-01

Nosocomial outbreaks, especially with (multi-)resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study sets out to provide a comparable overview of the costs of multiple outbreaks in a single academic hospital in the Netherlands. Based on interviews with the involved staff, multiple databases and stored records from the Infection Prevention Division all actions undertaken, extra staff employment, use of resources, bed-occupancy rates, and other miscellaneous cost drivers during different outbreaks were scored and quantified into Euros. This led to total costs per outbreak and an estimated average cost per positive patient per outbreak day. Seven outbreaks that occurred between 2012 and 2014 in the hospital were evaluated. Total costs for the hospital ranged between €10,778 and €356,754. Costs per positive patient per outbreak day, ranged between €10 and €1,369 (95% CI: €49-€1,042), with a mean of €546 and a median of €519. Majority of the costs (50%) were made because of closed beds. This analysis is the first to give a comparable overview of various outbreaks, caused by different microorganisms, in the same hospital and all analyzed with the same method. It shows a large variation within the average costs due to different factors (e.g. closure of wards, type of ward). All outbreaks however cost considerable amounts of efforts and money (up to €356,754), including missed revenue and control measures.

Cost-Analysis of Seven Nosocomial Outbreaks in an Academic Hospital.

Directory of Open Access Journals (Sweden)

Jan-Willem H Dik

Full Text Available Nosocomial outbreaks, especially with (multi-resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study sets out to provide a comparable overview of the costs of multiple outbreaks in a single academic hospital in the Netherlands.Based on interviews with the involved staff, multiple databases and stored records from the Infection Prevention Division all actions undertaken, extra staff employment, use of resources, bed-occupancy rates, and other miscellaneous cost drivers during different outbreaks were scored and quantified into Euros. This led to total costs per outbreak and an estimated average cost per positive patient per outbreak day.Seven outbreaks that occurred between 2012 and 2014 in the hospital were evaluated. Total costs for the hospital ranged between €10,778 and €356,754. Costs per positive patient per outbreak day, ranged between €10 and €1,369 (95% CI: €49-€1,042, with a mean of €546 and a median of €519. Majority of the costs (50% were made because of closed beds.This analysis is the first to give a comparable overview of various outbreaks, caused by different microorganisms, in the same hospital and all analyzed with the same method. It shows a large variation within the average costs due to different factors (e.g. closure of wards, type of ward. All outbreaks however cost considerable amounts of efforts and money (up to €356,754, including missed revenue and control measures.

Crisis prevention and management during SARS outbreak, Singapore.

Science.gov (United States)

Quah, Stella R; Hin-Peng, Lee

2004-02-01

We discuss crisis prevention and management during the first 3 months of the severe acute respiratory syndrome (SARS) outbreak in Singapore. Four public health issues were considered: prevention measures, self-health evaluation, SARS knowledge, and appraisal of crisis management. We conducted telephone interviews with a representative sample of 1,201 adults, > or = 21 years of age. We found that sex, age, and attitude (anxiety and perception of open communication with authorities) were associated with practicing preventive measures. Analysis of Singapore's outbreak improves our understanding of the social dimensions of infectious disease outbreaks.

[Outbreaks of viral hepatitis E in the Czech Republic?].

Science.gov (United States)

Trmal, Josef; Pavlík, Ivo; Vasícková, Petra; Matejícková, Ladislava; Simůnková, Lenka; Luks, Stanislav; Pazderková, Jana

2012-05-01

Until recently, viral hepatitis E (VHE) has typically been an imported infection, related to travel to developing countries. A number of travel-unrelated VHE cases currently diagnosed in the Czech Republic. Outcomes of the epidemiological investigations of two VHE outbreaks associated with the consumption of pork and pork products at pig-slaughtering feasts are presented. Thirteen cases have been reported in the first outbreak and eight cases in the second outbreak. The epidemiological investigations are described and the experience gained in analysing suspected biological specimens is presented. The source of infection has not been identified in the first outbreak while in the other one, a link between human cases and infection in farm pigs was revealed for the first time. Although the epidemiological investigation may not always lead to the detection of the VHE source, it must be conducted in any outbreak and can only be successful when done in cooperation of the public health authorities with the veterinary health agency.

Measles Outbreak among Unvaccinated Children in Bajura

Directory of Open Access Journals (Sweden)

S Sitaula

2010-12-01

CFR of this outbreak is higher than the national CFR. Vaccine efficacy of 50% points towards the need for investigation of vaccine logistics and cold chain system. Moreover, this laboratory test confirmed an outbreak showing that the measles virus could be imported from an endemic region and rapidly spread through a susceptible population who were previously not immunized.

Ebola Outbreak Containment: Real-Time Task and Resource Coordination With SORMAS

Directory of Open Access Journals (Sweden)

Cindy Perscheid

2018-04-01

Full Text Available Background: Since the beginning of the Ebola outbreak in West Africa in 2014, more than 11,000 people died. For outbreaks of infectious diseases like this, the rapid implementation of control measures is a crucial factor for containment. In West African countries, outbreak surveillance is a paper-based process with significant delays in forwarding outbreak information, which affects the ability to react adequately to situational changes. Our objective therefore was to develop a tool that improves data collection, situation assessment, and coordination of response measures in outbreak surveillance processes for a better containment.Methods: We have developed the Surveillance and Outbreak Response Management System (SORMAS based on findings from Nigeria's 2014 Ebola outbreak. We conducted a thorough requirements engineering and defined personas and processes. We also defined a data schema with specific variables to measure in outbreak situations. We designed our system to be a cloud application that consists of interfaces for both mobile devices and desktop computers to support all stakeholders in the process. In the field, health workers collect data on the outbreak situation via mobile applications and directly transmit it to control centers. At the control centers, health workers access SORMAS via desktop computers, receive instant updates on critical situations, react immediately on emergencies, and coordinate the implementation of control measures with SORMAS.Results: We have tested SORMAS in multiple workshops and a field study in July 2015. Results from workshops confirmed derived requirements and implemented features, but also led to further iterations on the systems regarding usability. Results from the field study are currently under assessment. General feedback showed high enthusiasm about the system and stressed its benefits for an effective outbreak containment of infectious diseases.Conclusions: SORMAS is a software tool to support

Human angiostrongyliasis outbreak in Dali, China.

Science.gov (United States)

Lv, Shan; Zhang, Yi; Chen, Shao-Rong; Wang, Li-Bo; Fang, Wen; Chen, Feng; Jiang, Jin-Yong; Li, Yuan-Lin; Du, Zun-Wei; Zhou, Xiao-Nong

2009-09-22

Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection. All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF). Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations. The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education campaigns could limit the risk, and a hospital-based surveillance system should be

Building test data from real outbreaks for evaluating detection algorithms.

Science.gov (United States)

Texier, Gaetan; Jackson, Michael L; Siwe, Leonel; Meynard, Jean-Baptiste; Deparis, Xavier; Chaudet, Herve

2017-01-01

Benchmarking surveillance systems requires realistic simulations of disease outbreaks. However, obtaining these data in sufficient quantity, with a realistic shape and covering a sufficient range of agents, size and duration, is known to be very difficult. The dataset of outbreak signals generated should reflect the likely distribution of authentic situations faced by the surveillance system, including very unlikely outbreak signals. We propose and evaluate a new approach based on the use of historical outbreak data to simulate tailored outbreak signals. The method relies on a homothetic transformation of the historical distribution followed by resampling processes (Binomial, Inverse Transform Sampling Method-ITSM, Metropolis-Hasting Random Walk, Metropolis-Hasting Independent, Gibbs Sampler, Hybrid Gibbs Sampler). We carried out an analysis to identify the most important input parameters for simulation quality and to evaluate performance for each of the resampling algorithms. Our analysis confirms the influence of the type of algorithm used and simulation parameters (i.e. days, number of cases, outbreak shape, overall scale factor) on the results. We show that, regardless of the outbreaks, algorithms and metrics chosen for the evaluation, simulation quality decreased with the increase in the number of days simulated and increased with the number of cases simulated. Simulating outbreaks with fewer cases than days of duration (i.e. overall scale factor less than 1) resulted in an important loss of information during the simulation. We found that Gibbs sampling with a shrinkage procedure provides a good balance between accuracy and data dependency. If dependency is of little importance, binomial and ITSM methods are accurate. Given the constraint of keeping the simulation within a range of plausible epidemiological curves faced by the surveillance system, our study confirms that our approach can be used to generate a large spectrum of outbreak signals.

Building test data from real outbreaks for evaluating detection algorithms.

Directory of Open Access Journals (Sweden)

Gaetan Texier

Full Text Available Benchmarking surveillance systems requires realistic simulations of disease outbreaks. However, obtaining these data in sufficient quantity, with a realistic shape and covering a sufficient range of agents, size and duration, is known to be very difficult. The dataset of outbreak signals generated should reflect the likely distribution of authentic situations faced by the surveillance system, including very unlikely outbreak signals. We propose and evaluate a new approach based on the use of historical outbreak data to simulate tailored outbreak signals. The method relies on a homothetic transformation of the historical distribution followed by resampling processes (Binomial, Inverse Transform Sampling Method-ITSM, Metropolis-Hasting Random Walk, Metropolis-Hasting Independent, Gibbs Sampler, Hybrid Gibbs Sampler. We carried out an analysis to identify the most important input parameters for simulation quality and to evaluate performance for each of the resampling algorithms. Our analysis confirms the influence of the type of algorithm used and simulation parameters (i.e. days, number of cases, outbreak shape, overall scale factor on the results. We show that, regardless of the outbreaks, algorithms and metrics chosen for the evaluation, simulation quality decreased with the increase in the number of days simulated and increased with the number of cases simulated. Simulating outbreaks with fewer cases than days of duration (i.e. overall scale factor less than 1 resulted in an important loss of information during the simulation. We found that Gibbs sampling with a shrinkage procedure provides a good balance between accuracy and data dependency. If dependency is of little importance, binomial and ITSM methods are accurate. Given the constraint of keeping the simulation within a range of plausible epidemiological curves faced by the surveillance system, our study confirms that our approach can be used to generate a large spectrum of outbreak

The highly virulent 2006 Norwegian EHEC O103:H25 outbreak strain is related to the 2011 German O104:H4 outbreak strain.

Directory of Open Access Journals (Sweden)

Trine M L'Abée-Lund

Full Text Available In 2006, a severe foodborne EHEC outbreak occured in Norway. Seventeen cases were recorded and the HUS frequency was 60%. The causative strain, Esherichia coli O103:H25, is considered to be particularly virulent. Sequencing of the outbreak strain revealed resemblance to the 2011 German outbreak strain E. coli O104:H4, both in genome and Shiga toxin 2-encoding (Stx2 phage sequence. The nucleotide identity between the Stx2 phages from the Norwegian and German outbreak strains was 90%. During the 2006 outbreak, stx(2-positive O103:H25 E. coli was isolated from two patients. All the other outbreak associated isolates, including all food isolates, were stx-negative, and carried a different phage replacing the Stx2 phage. This phage was of similar size to the Stx2 phage, but had a distinctive early phage region and no stx gene. The sequence of the early region of this phage was not retrieved from the bacterial host genome, and the origin of the phage is unknown. The contaminated food most likely contained a mixture of E. coli O103:H25 cells with either one of the phages.

Genetic architecture and phenotypic plasticity of thermally-regulated traits in an eruptive species, Dendroctonus ponderosae

Science.gov (United States)

Barbara J. Bentz; Ryan B. Bracewell; Karen E. Mock; Michael E. Pfrender

2011-01-01

Phenotypic plasticity in thermally-regulated traits enables close tracking of changing environmental conditions, and can thereby enhance the potential for rapid population increase, a hallmark of outbreak insect species. In a changing climate, exposure to conditions that exceed the capacity of existing phenotypic plasticity may occur. Combining information on genetic...

National Outbreak Reporting System

Data.gov (United States)

U.S. Department of Health & Human Services — The National Outbreak Reporting System (NORS) is a web-based platform designed to support reporting to CDC by local, state, and territorial health departments in the...

Detection and forecasting of oyster norovirus outbreaks: recent advances and future perspectives.

Science.gov (United States)

Wang, Jiao; Deng, Zhiqiang

2012-09-01

Norovirus is a highly infectious pathogen that is commonly found in oysters growing in fecally contaminated waters. Norovirus outbreaks can cause the closure of oyster harvesting waters and acute gastroenteritis in humans associated with consumption of contaminated raw oysters. Extensive efforts and progresses have been made in detection and forecasting of oyster norovirus outbreaks over the past decades. The main objective of this paper is to provide a literature review of methods and techniques for detecting and forecasting oyster norovirus outbreaks and thereby to identify the future directions for improving the detection and forecasting of norovirus outbreaks. It is found that (1) norovirus outbreaks display strong seasonality with the outbreak peak occurring commonly in December-March in the U.S. and April-May in the Europe; (2) norovirus outbreaks are affected by multiple environmental factors, including but not limited to precipitation, temperature, solar radiation, wind, and salinity; (3) various modeling approaches may be employed to forecast norovirus outbreaks, including Bayesian models, regression models, Artificial Neural Networks, and process-based models; and (4) diverse techniques are available for near real-time detection of norovirus outbreaks, including multiplex PCR, seminested PCR, real-time PCR, quantitative PCR, and satellite remote sensing. The findings are important to the management of oyster growing waters and to future investigations into norovirus outbreaks. It is recommended that a combined approach of sensor-assisted real time monitoring and modeling-based forecasting should be utilized for an efficient and effective detection and forecasting of norovirus outbreaks caused by consumption of contaminated oysters. Copyright © 2012 Elsevier Ltd. All rights reserved.

Measles outbreak investigation in Guji zone of Oromia Region, Ethiopia.

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Belda, Ketema; Tegegne, Ayesheshem Ademe; Mersha, Amare Mengistu; Bayenessagne, Mekonnen Getahun; Hussein, Ibrahim; Bezabeh, Belay

2017-01-01

Despite the increase of immunization coverage (administrative) of measles in the country, there are widespread outbreaks of measles. In this respect, we investigated one of the outbreaks that occurred in hard to reach kebeles of Guji Zone, Oromia region, to identify the contributing factors that lead to the protracted outbreak of measles. We used a cross-sectional study design to investigate a measles outbreak in Guji zone, Oromia region. Data entry and analysis was performed using EPI-Info version 7.1.0.6 and MS-Microsoft Excel. In three months' time a total of 1059 suspected cases and two deaths were reported from 9 woredas affected by a measles outbreak in Guji zone. The cumulative attack rate of 81/100,000 population and case fatality ratio of 0.2% was recorded. Of these, 821 (77.5%) cases were measles vaccine. Although, all age groups were affected under five years old were more affected 495 (48%) than any other age groups. In response to the outbreak, an outbreak response immunization was organized at the 11th week of the epidemic, when the epidemic curve started to decline. 6 months to14 years old were targeted for outbreak response immunization and the overall coverage was 97 % (range: 90-103%). Case management with vitamin A supplementation, active case search, and health education was some of the activities carried out to curb the outbreak. We conclude that low routine immunization coverage in conjunction with low access to routine immunization in hard to reach areas, low community awareness in utilization of immunization service, inadequate cold chain management and delivery of a potent vaccine in hard to reach woredas/kebeles were likely contributed to the outbreak that's triggered a broad spread epidemic affecting mostly children without any vaccination. We also figured that the case-based surveillance lacks sensitivity and timely confirmation of the outbreak, which as a result outbreak response immunization were delayed. We recommend establishing

Swine flu - A pandemic outbreak

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Jini George

Full Text Available Hippocrates had described influenza like outbreak in 412 B.C. and since then repeated influenza like epidemics and pandemics have been recorded in recent times. One of the greatest killers of all time was the pandemic of swine flu (Spanish flu of 1918-1919, when 230 million people died. Annual influenza epidemics are estimated to affect 5–15% of the global population, resulting in severe illness in 3–5 million patients causing 250,000–500,000 deaths worldwide. Severe illness and deaths occur mainly in the high-risk populations of infants, the elderly and chronically ill patients. The 2009 outbreak of swine flu is thought to be a mutation more specifically a reassortment of four known strains of influenza A virus subtype H1N1; one endemic in humans, one endemic in birds, and two endemic in pigs. WHO officially declared the outbreak to be a pandemic on June 11, 2009, but stressed that the new designation was a result of the global "spread of the virus," not its severity. [Vet World 2009; 2(12.000: 472-474

Additional value of typing Noroviruses in gastroenteritis outbreaks in Amsterdam, The Netherlands.

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Koek, A G; Bovée, L P M J; van den Hoek, J A R; Bos, A J; Bruisten, S M

2006-02-01

In Amsterdam, 17 of the 55 gastroenteritis (GI) outbreaks reported from January 2002 to May 2003 were confirmed to be caused by noroviruses (NV). In this study, we describe the molecular epidemiology of a group of nine outbreaks associated with a catering firm and two outbreaks, 5 months apart, in an Amsterdam hospital. All outbreaks were typed to confirm their linkage, and the hospital-related cases were studied to see if the two outbreaks were caused by one persisting NV strain or by a reintroduction after 5 months. For the outbreaks associated with the catering firm one NV genogroup I strain was found which was identical in sequence among customers and employees of the caterer. This was not the strain that predominantly circulated in 2002/2003 in and around Amsterdam, which was the NV genogroup II4 "new variant" (GgII4nv) strain. In the Amsterdam hospital, the two outbreaks were caused by this predominant GgII4nv type, and we argue that NV was most likely reintroduced in the second outbreak from the Amsterdam community.

Mitigating measles outbreaks in West Africa post-Ebola.

Science.gov (United States)

Truelove, Shaun A; Moss, William J; Lessler, Justin

2015-01-01

The Ebola outbreak in 2014-2015 devastated the populations, economies and healthcare systems of Guinea, Liberia and Sierra Leone. With this devastation comes the impending threat of outbreaks of other infectious diseases like measles. Strategies for mitigating these risks must include both prevention, through vaccination, and case detection and management, focused on surveillance, diagnosis and appropriate clinical care and case management. With the high transmissibility of measles virus, small-scale reactive vaccinations will be essential to extinguish focal outbreaks, while national vaccination campaigns are needed to guarantee vaccination coverage targets are reached in the long term. Rapid and multifaceted strategies should carefully navigate challenges present in the wake of Ebola, while also taking advantage of current Ebola-related activities and international attention. Above all, resources and focus currently aimed at these countries must be utilized to build up the deficit in infrastructure and healthcare systems that contributed to the extent of the Ebola outbreak.

Surveillance for waterborne disease outbreaks associated with drinking water---United States, 2007--2008.

Science.gov (United States)

Brunkard, Joan M; Ailes, Elizabeth; Roberts, Virginia A; Hill, Vincent; Hilborn, Elizabeth D; Craun, Gunther F; Rajasingham, Anu; Kahler, Amy; Garrison, Laurel; Hicks, Lauri; Carpenter, Joe; Wade, Timothy J; Beach, Michael J; Yoder Msw, Jonathan S

2011-09-23

Since 1971, CDC, the Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists have collaborated on the Waterborne Disease and Outbreak Surveillance System (WBDOSS) for collecting and reporting data related to occurrences and causes of waterborne disease outbreaks associated with drinking water. This surveillance system is the primary source of data concerning the scope and health effects of waterborne disease outbreaks in the United States. Data presented summarize 48 outbreaks that occurred during January 2007--December 2008 and 70 previously unreported outbreaks. WBDOSS includes data on outbreaks associated with drinking water, recreational water, water not intended for drinking (WNID) (excluding recreational water), and water use of unknown intent (WUI). Public health agencies in the states, U.S. territories, localities, and Freely Associated States are primarily responsible for detecting and investigating outbreaks and reporting them voluntarily to CDC by a standard form. Only data on outbreaks associated with drinking water, WNID (excluding recreational water), and WUI are summarized in this report. Outbreaks associated with recreational water are reported separately. A total of 24 states and Puerto Rico reported 48 outbreaks that occurred during 2007--2008. Of these 48 outbreaks, 36 were associated with drinking water, eight with WNID, and four with WUI. The 36 drinking water--associated outbreaks caused illness among at least 4,128 persons and were linked to three deaths. Etiologic agents were identified in 32 (88.9%) of the 36 drinking water--associated outbreaks; 21 (58.3%) outbreaks were associated with bacteria, five (13.9%) with viruses, three (8.3%) with parasites, one (2.8%) with a chemical, one (2.8%) with both bacteria and viruses, and one (2.8%) with both bacteria and parasites. Four outbreaks (11.1%) had unidentified etiologies. Of the 36 drinking water--associated outbreaks, 22 (61.1%) were outbreaks of

Legionnaires' Disease Outbreaks and Cooling Towers, New York City, New York, USA.

Science.gov (United States)

Fitzhenry, Robert; Weiss, Don; Cimini, Dan; Balter, Sharon; Boyd, Christopher; Alleyne, Lisa; Stewart, Renee; McIntosh, Natasha; Econome, Andrea; Lin, Ying; Rubinstein, Inessa; Passaretti, Teresa; Kidney, Anna; Lapierre, Pascal; Kass, Daniel; Varma, Jay K

2017-11-01

The incidence of Legionnaires' disease in the United States has been increasing since 2000. Outbreaks and clusters are associated with decorative, recreational, domestic, and industrial water systems, with the largest outbreaks being caused by cooling towers. Since 2006, 6 community-associated Legionnaires' disease outbreaks have occurred in New York City, resulting in 213 cases and 18 deaths. Three outbreaks occurred in 2015, including the largest on record (138 cases). Three outbreaks were linked to cooling towers by molecular comparison of human and environmental Legionella isolates, and the sources for the other 3 outbreaks were undetermined. The evolution of investigation methods and lessons learned from these outbreaks prompted enactment of a new comprehensive law governing the operation and maintenance of New York City cooling towers. Ongoing surveillance and program evaluation will determine if enforcement of the new cooling tower law reduces Legionnaires' disease incidence in New York City.

Developing a climate-based risk map of fascioliasis outbreaks in Iran

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Mansour Halimi

2015-09-01

Full Text Available Summary: The strong relationship between climate and fascioliasis outbreaks enables the development of climate-based models to estimate the potential risk of fascioliasis outbreaks. This work aims to develop a climate-based risk map of fascioliasis outbreaks in Iran using Ollerenshaw's fascioliasis risk index incorporating geographical information system (GIS. Using this index, a risk map of fascioliasis outbreaks for the entire country was developed. We determined that the country can be divided into 4 fascioliasis outbreak risk categories. Class 1, in which the Mt value is less than 100, includes more than 0.91 of the country's area. The climate in this class is not conducive to fascioliasis outbreaks in any month. Dryness and low temperature in the wet season (December to April are the key barriers against fascioliasis outbreaks in this class. The risk map developed based on climatic factors indicated that only 0.03 of the country's area, including Gilan province in the northern region of Iran, is highly suitable to fascioliasis outbreaks during September to January. The Mt value is greater than 500 in this class. Heavy rainfall in the summer and fall, especially in Rasht, Astara and Bandar Anzaly (≥1000 mm/year, creates more suitable breeding places for snail intermediate hosts. Keywords: Ollerenshaw fascioliasis risk index, Climate, Gilan province, Iran

Developing a climate-based risk map of fascioliasis outbreaks in Iran.

Science.gov (United States)

Halimi, Mansour; Farajzadeh, Manuchehr; Delavari, Mahdi; Arbabi, Mohsen

2015-01-01

The strong relationship between climate and fascioliasis outbreaks enables the development of climate-based models to estimate the potential risk of fascioliasis outbreaks. This work aims to develop a climate-based risk map of fascioliasis outbreaks in Iran using Ollerenshaw's fascioliasis risk index incorporating geographical information system (GIS). Using this index, a risk map of fascioliasis outbreaks for the entire country was developed. We determined that the country can be divided into 4 fascioliasis outbreak risk categories. Class 1, in which the Mt value is less than 100, includes more than 0.91 of the country's area. The climate in this class is not conducive to fascioliasis outbreaks in any month. Dryness and low temperature in the wet season (December to April) are the key barriers against fascioliasis outbreaks in this class. The risk map developed based on climatic factors indicated that only 0.03 of the country's area, including Gilan province in the northern region of Iran, is highly suitable to fascioliasis outbreaks during September to January. The Mt value is greater than 500 in this class. Heavy rainfall in the summer and fall, especially in Rasht, Astara and Bandar Anzaly (≥ 1000 mm/year), creates more suitable breeding places for snail intermediate hosts. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Investigating Listeria Outbreaks

Centers for Disease Control (CDC) Podcasts

2013-01-04

Dr. Emily Cartwright, Infectious Disease fellow at Emory University and former EIS Officer with CDC’s Division of Foodborne, Waterborne, and Environmental Diseases discusses foodborne Listeria outbreaks.  Created: 1/4/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/8/2013.

Ebola virus outbreak, updates on current therapeutic strategies.

Science.gov (United States)

Elshabrawy, Hatem A; Erickson, Timothy B; Prabhakar, Bellur S

2015-07-01

Filoviruses are enveloped negative-sense single-stranded RNA viruses, which include Ebola and Marburg viruses, known to cause hemorrhagic fever in humans with a case fatality of up to 90%. There have been several Ebola virus outbreaks since the first outbreak in the Democratic Republic of Congo in 1976 of which, the recent 2013-2015 epidemic in Guinea, Liberia, and Sierra Leone is the largest in recorded history. Within a few months of the start of the outbreak in December 2013, thousands of infected cases were reported with a significant number of deaths. As of March 2015, according to the Centers for Disease Control and Prevention, there have been nearly 25,000 suspected cases, with 15,000 confirmed by laboratory testing, and over 10,000 deaths. The large number of cases and the high mortality rate, combined with the lack of effective Food and Drug Administration-approved treatments, necessitate the development of potent and safe therapeutic measures to combat the current and future outbreaks. Since the beginning of the outbreak, there have been considerable efforts to develop and characterize protective measures including vaccines and antiviral small molecules, and some have proven effective in vitro and in animal models. Most recently, a cocktail of monoclonal antibodies has been shown to be highly effective in protecting non-human primates from Ebola virus infection. In this review, we will discuss what is known about the nature of the virus, phylogenetic classification, genomic organization and replication, disease transmission, and viral entry and highlight the current approaches and efforts, in the development of therapeutics, to control the outbreak. Copyright © 2015 John Wiley & Sons, Ltd.

Societal learning in epidemics: intervention effectiveness during the 2003 SARS outbreak in Singapore.

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John M Drake

Full Text Available BACKGROUND: Rapid response to outbreaks of emerging infectious diseases is impeded by uncertain diagnoses and delayed communication. Understanding the effect of inefficient response is a potentially important contribution of epidemic theory. To develop this understanding we studied societal learning during emerging outbreaks wherein patient removal accelerates as information is gathered and disseminated. METHODS AND FINDINGS: We developed an extension of a standard outbreak model, the simple stochastic epidemic, which accounts for societal learning. We obtained expressions for the expected outbreak size and the distribution of epidemic duration. We found that rapid learning noticeably affects the final outbreak size even when learning exhibits diminishing returns (relaxation. As an example, we estimated the learning rate for the 2003 outbreak of severe acute respiratory syndrome (SARS in Singapore. Evidence for relaxation during the first eight weeks of the outbreak was inconclusive. We estimated that if societal learning had occurred at half the actual rate, the expected final size of the outbreak would have reached nearly 800 cases, more than three times the observed number of infections. By contrast, the expected outbreak size for societal learning twice as effective was 116 cases. CONCLUSION: These results show that the rate of societal learning can greatly affect the final size of disease outbreaks, justifying investment in early warning systems and attentiveness to disease outbreak by both government authorities and the public. We submit that the burden of emerging infections, including the risk of a global pandemic, could be efficiently reduced by improving procedures for rapid detection of outbreaks, alerting public health officials, and aggressively educating the public at the start of an outbreak.

Simple visit behavior unifies complex Zika outbreaks

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P.D. Manrique

2017-12-01

Full Text Available New outbreaks of Zika in the U.S. are imminent. Human nature dictates that many individuals will continue to revisit affected ‘Ground Zero’ patches, whether out of choice, work or family reasons − yet this feature is missing from traditional epidemiological analyses. Here we show that this missing visit-revisit mechanism is by itself capable of explaining quantitatively the 2016 human Zika outbreaks in all three Ground Zero patches. Our findings reveal counterintuitive ways in which this human flow can be managed to tailor any future outbreak’s duration, severity and time-to-peak. Effective public health planning can leverage these results to impact the evolution of future outbreaks via soft control of the overall human flow, as well as to suggest best-practice visitation behavior for local residents.

An Outbreak of Foodborne Botulism in Ontario

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Mona R Loutfy

2003-01-01

Full Text Available Botulism is a rare paralytic illness resulting from a potent neurotoxin produced by Clostridium botulinum. Botulism in Canada is predominately due to C botulinum type E and affects mainly the First Nations and Inuit populations. The most recent outbreak of botulism in Ontario was in Ottawa in 1991 and was caused by C botulinum type A. We report an outbreak of foodborne type B botulism in Ontario, which implicated home-canned tomatoes. The outbreak was characterized by mild symptoms in two cases and moderately severe illness in one case. The investigation shows the importance of considering the diagnosis of botulism in patients presenting with cranial nerve and autonomic dysfunction, especially when combined with gastrointestinal complaints; it also highlights the importance of proper home canning technique.

Measles outbreaks affecting children in Jewish ultra-orthodox communities in Jerusalem

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STEIN-ZAMIR, C.; ZENTNER, G.; ABRAMSON, N.; SHOOB, H.; ABOUDY, Y.; SHULMAN, L.; MENDELSON, E.

2008-01-01

SUMMARY In 2003 and 2004 two measles outbreaks occurred in Jewish ultra-orthodox communities in Jerusalem. The index case of the first outbreak (March 2003) was a 2-year-old unvaccinated child from Switzerland. Within 5 months, 107 cases (mean age 8·3±7·5 years) emerged in three crowded neighbourhoods. The first cases of the second outbreak (June 2004) were in three girls aged 4–5 years in one kindergarten in another community. By November 2004, 117 cases (mean age 7·3±6·5 years) occurred. The virus genotypes were D8 and D4 respectively. Altogether, 96 households accounted for the two outbreaks, with two or more patients per family in 79% of cases. Most cases (91·5%) were unvaccinated. Immunization coverage was lower in outbreak than in non-outbreak neighbourhoods (88·3% vs. 90·3%, P=0·001). Controlling the outbreaks necessitated a culture-sensitive approach, and targeted efforts increased MMR vaccine coverage (first dose) to 95·2%. Despite high national immunization coverage (94–95%), special attention to specific sub-populations is essential. PMID:17433131

Outbreaks of virulent diarrheagenic Escherichia coli - are we in control?

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Werber Dirk

2012-02-01

Full Text Available Abstract Shiga toxin-producing Escherichia coli (STEC are the most virulent diarrheagenic E. coli known to date. They can be spread with alarming ease via food as exemplified by a large sprout-borne outbreak of STEC O104:H4 in 2011 that was centered in northern Germany and affected several countries. Effective control of such outbreaks is an important public health task and necessitates early outbreak detection, fast identification of the outbreak vehicle and immediate removal of the suspected food from the market, flanked by consumer advice and measures to prevent secondary spread. In our view, opportunities to improve control of STEC outbreaks lie in early clinical suspicion for STEC infection, timely diagnosis of all STEC at the serotype-level and integrating molecular subtyping information into surveillance systems. Furthermore, conducting analytical studies that supplement patients' imperfect food history recall and performing, as an investigative element, product tracebacks, are pivotal but underutilized tools for successful epidemiologic identification of the suspected vehicle in foodborne outbreaks. As a corollary, these tools are amenable to tailor microbiological testing of suspected food. Please see related article: http://www.biomedcentral.com/1741-7015/10/12

The importance of waterborne disease outbreak surveillance in the United States

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Gunther Franz Craun

2012-12-01

Full Text Available Analyses of the causes of disease outbreaks associated with contaminated drinking water in the United States have helped inform prevention efforts at the national, state, and local levels. This article describes the changing nature of disease outbreaks in public water systems during 1971-2008 and discusses the importance of a collaborative waterborne outbreak surveillance system established in 1971. Increasing reports of outbreaks throughout the early 1980s emphasized that microbial contaminants remained a health-risk challenge for suppliers of drinking water. Outbreak investigations identified the responsible etiologic agents and deficiencies in the treatment and distribution of drinking water, especially the high risk associated with unfiltered surface water systems. Surveillance information was important in establishing an effective research program that guided government regulations and industry actions to improve drinking water quality. Recent surveillance statistics suggest that prevention efforts based on these research findings have been effective in reducing outbreak risks especially for surface water systems.

Mumps outbreak in Israel's highly vaccinated society: are two doses enough?

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Anis, E; Grotto, I; Moerman, L; Warshavsky, B; Slater, P E; Lev, B

2012-03-01

Mumps outbreaks in recent years have given rise to questions about the effectiveness of the mumps vaccine. This study examined the epidemiological data from a recent mumps outbreak in Israel and from outbreaks in other countries with high vaccination coverage, and considered whether long-established vaccination policies designed to protect against mumps are in need of revision. Of over 5000 case patients in the Israeli outbreak, half of whom were in the Jerusalem health district, nearly 40% were aged ≥15 years and, of those whose vaccination status was known, 78% had been fully vaccinated for their age - features similar to those in recent mumps outbreaks in Europe and North America. The epidemiological and laboratory evidence suggests that many previously vaccinated adolescents and young adults are now susceptible to mumps because their vaccine-based immunity has waned. Booster vaccination programmes for those at high risk of infection during mumps outbreaks - particularly those in congregate living environments - merit priority consideration.

Responding to Outbreaks

Centers for Disease Control (CDC) Podcasts

2009-04-27

In this podcast, a team of CDC specialists travels to Uganda and tracks the source of an Ebola outbreak where CDC scientists are studying bats for clues to the Ebola mystery.  Created: 4/27/2009 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/27/2009.

Literature Review of Associations among Attributes of Reported Drinking Water Disease Outbreaks

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Grant Ligon

2016-05-01

Full Text Available Waterborne disease outbreaks attributed to various pathogens and drinking water system characteristics have adversely affected public health worldwide throughout recorded history. Data from drinking water disease outbreak (DWDO reports of widely varying breadth and depth were synthesized to investigate associations between outbreak attributes and human health impacts. Among 1519 outbreaks described in 475 sources identified during review of the primarily peer-reviewed, English language literature, most occurred in the U.S., the U.K. and Canada (in descending order. The outbreaks are most frequently associated with pathogens of unknown etiology, groundwater and untreated systems, and catchment realm-associated deficiencies (i.e., contamination events. Relative frequencies of outbreaks by various attributes are comparable with those within other DWDO reviews, with water system size and treatment type likely driving most of the (often statistically-significant at p < 0.05 differences in outbreak frequency, case count and attack rate. Temporal analysis suggests that while implementation of surface (drinking water management policies is associated with decreased disease burden, further strengthening of related policies is needed to address the remaining burden attributed to catchment and distribution realm-associated deficiencies and to groundwater viral and disinfection-only system outbreaks.

Perceptions of vulnerability to a future outbreak: a study of horse managers affected by the first Australian equine influenza outbreak

Science.gov (United States)

2013-01-01

Background A growing body of work shows the benefits of applying social cognitive behavioural theory to investigate infection control and biosecurity practices. Protection motivation theory has been used to predict protective health behaviours. The theory outlines that a perception of a lack of vulnerability to a disease contributes to a reduced threat appraisal, which results in poorer motivation, and is linked to poorer compliance with advised health protective behaviours. This study, conducted following the first-ever outbreak of equine influenza in Australia in 2007, identified factors associated with horse managers’ perceived vulnerability to a future equine influenza outbreak. Results Of the 200 respondents, 31.9% perceived themselves to be very vulnerable, 36.6% vulnerable and 31.4% not vulnerable to a future outbreak of equine influenza. Multivariable logistic regression modelling revealed that managers involved in horse racing and those on rural horse premises perceived themselves to have low levels of vulnerability. Managers of horse premises that experienced infection in their horses in 2007 and those seeking infection control information from specific sources reported increased levels of perceived vulnerability to a future outbreak. Conclusion Different groups across the horse industry perceived differing levels of vulnerability to a future outbreak. Increased vulnerability contributes to favourable infection control behaviour and hence these findings are important for understanding uptake of recommended infection control measures. Future biosecurity communication strategies should be delivered through information sources suitable for the horse racing and rural sectors. PMID:23902718

Perceptions of vulnerability to a future outbreak: a study of horse managers affected by the first Australian equine influenza outbreak.

Science.gov (United States)

Schemann, Kathrin; Firestone, Simon M; Taylor, Melanie R; Toribio, Jenny-Ann L M L; Ward, Michael P; Dhand, Navneet K

2013-07-31

A growing body of work shows the benefits of applying social cognitive behavioural theory to investigate infection control and biosecurity practices. Protection motivation theory has been used to predict protective health behaviours. The theory outlines that a perception of a lack of vulnerability to a disease contributes to a reduced threat appraisal, which results in poorer motivation, and is linked to poorer compliance with advised health protective behaviours. This study, conducted following the first-ever outbreak of equine influenza in Australia in 2007, identified factors associated with horse managers' perceived vulnerability to a future equine influenza outbreak. Of the 200 respondents, 31.9% perceived themselves to be very vulnerable, 36.6% vulnerable and 31.4% not vulnerable to a future outbreak of equine influenza. Multivariable logistic regression modelling revealed that managers involved in horse racing and those on rural horse premises perceived themselves to have low levels of vulnerability. Managers of horse premises that experienced infection in their horses in 2007 and those seeking infection control information from specific sources reported increased levels of perceived vulnerability to a future outbreak. Different groups across the horse industry perceived differing levels of vulnerability to a future outbreak. Increased vulnerability contributes to favourable infection control behaviour and hence these findings are important for understanding uptake of recommended infection control measures. Future biosecurity communication strategies should be delivered through information sources suitable for the horse racing and rural sectors.

A large rubella outbreak with spread from the workplace to the community.

Science.gov (United States)

Danovaro-Holliday, M C; LeBaron, C W; Allensworth, C; Raymond, R; Borden, T G; Murray, A B; Icenogle, J P; Reef, S E

2000-12-06

Childhood vaccination has reduced rubella disease to low levels in the United States, but outbreaks continue to occur. The largest outbreak in the past 5 years occurred in Nebraska in 1999. To examine risk factors for disease, susceptibility of the risk population, role of vaccine failure, and the need for new vaccination strategies in response to the Nebraska rubella outbreak. Investigation of 83 confirmed rubella cases occurring in Douglas County, Nebraska, between March 23 and August 24, 1999; serosurvey of 413 pregnant women in the outbreak locale between October 1998 and March 1999 (prior to outbreak) and April and November 1999 (during and after outbreak). Case characteristics, compared with that of the general county population; area childhood rubella vaccination rates; and susceptibility among pregnant women before vs during and after the outbreak. All 83 rubella cases were unvaccinated or had unknown vaccination status and fell into 3 groups: (1) 52 (63%) were young adults (median age, 26 years), 83% of whom were born in Latin American countries where rubella vaccination was not routine. They were either employed in meatpacking plants or were their household contacts. Attack rates in the plants were high (14.4 per 1000 vs 0. 19 per 1000 for general county population); (2) 16 (19%), including 14 children (9 of whom were aged pregnant women, susceptibility rates were 13% before the outbreak and 11% during and after the outbreak. Six (25%) of 24 susceptible women tested were seropositive for rubella IgM. Rubella vaccination rates were 90.2% for preschool children and 99.8% for school-aged children. A large rubella outbreak occurred among unvaccinated persons in a community with high immunity levels. Crowded working and living conditions facilitated transmission, but vaccine failure did not. Workplace vaccination could be considered to prevent similar outbreaks. JAMA. 2000;284:2733-2739.

Outbreaks of forest defoliating insects in Japan, 1950-2000.

Science.gov (United States)

Kamata, N; Kamata, N

2002-04-01

In Japan, several forest-defoliating insects reach outbreak levels and cause serious defoliation. Stand mortality sometimes occurs after severe defoliation. However, in general, tree mortality caused by insect defoliation is low because of the prevailing moist climate in Japan. Evergreen conifers are more susceptible to tree mortality as a result of insect defoliation whereas deciduous broad-leaved trees are seldom killed. Insect defoliation occurs more frequently in man-made environments such as among shade trees, orchards, and plantations than in natural habitats. Outbreaks of some defoliators tend to occur in stands of a particular age: e.g. outbreaks of the pine caterpillar, Dendrolimus spectabilis Butler (Lepidoptera: Lasiocampidae) occur more frequently in young pine plantations. In contrast, defoliation caused by outbreaks of lepidopterous and hymenopterous pests in larch plantations is more frequent with stand maturation. There is a relationship between outbreaks of some defoliators and altitude above sea level. Most outbreaks of forest defoliators were terminated by insect pathogens that operated in a density-dependent fashion. Since the 1970s, Japan has been prosperous and can afford to buy timber from abroad. More recently, there has been an increasing demand for timber in Japan, that coincides with a huge demand internationally, so that the country will need to produce more timber locally in the future. The increasing pressure on the forestry industry to meet this demand will require more sophisticated methods of pest control coupled with more sustainable methods of silviculture.

Comparing "insider" and "outsider" news coverage of the 2014 Ebola outbreak.

Science.gov (United States)

Humphries, Brittany; Radice, Martha; Lauzier, Sophie

2017-11-09

Information provided by news media during an infectious disease outbreak can affect the actions taken to safeguard public health. There has been little evaluation of how the content of news published during an outbreak varies by location of the news outlet. This study analyzes coverage of the 2014 Ebola outbreak by one news outlet operating within a country affected by the outbreak and one country not directly affected. A qualitative content analysis was conducted of articles published in two national news outlets, The Globe and Mail (Canada) and the Vanguard (Nigeria), between January 1 and December 31, 2014. Articles available through LexisNexis Academic were sorted by date and sampled using a stratified sampling method (The Globe and Mail n = 100; Vanguard n = 105). A coding scheme was developed and modified to incorporate emerging themes until saturation was achieved. There were substantial differences in outbreak coverage in terms of the topic and content of the articles, as well as the sources consulted. The Globe and Mail framed the outbreak in terms of national security and national interests, as well as presenting it as an international humanitarian crisis. In contrast, the Vanguard framed the outbreak almost exclusively in terms of public health. Our findings highlight how different geographic contexts can shape reporting on the same event. Further research is required to investigate how the political, social or economic situations of a country shape its news media, potentially influencing actions taken to control disease outbreaks.

Human angiostrongyliasis outbreak in Dali, China.

Directory of Open Access Journals (Sweden)

Shan Lv

Full Text Available BACKGROUND: Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection. METHODOLOGY/PRINCIPAL FINDINGS: All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF. Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations. CONCLUSIONS/SIGNIFICANCE: The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education

Molecular Characterization of Two Major Dengue Outbreaks in Costa Rica.

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Soto-Garita, Claudio; Somogyi, Teresita; Vicente-Santos, Amanda; Corrales-Aguilar, Eugenia

2016-07-06

Dengue virus (DENV) (Flavivirus, Flaviviridae) is a reemerging arthropod-borne virus with a worldwide circulation, transmitted mainly by Aedes aegypti and Aedes albopictus mosquitoes. Since the first detection of its main transmitting vector in 1992 and the invasion of DENV-1 in 1993, Costa Rica has faced dengue outbreaks yearly. In 2007 and 2013, Costa Rica experienced two of the largest outbreaks in terms of total and severe cases. To provide genetic information about the etiologic agents producing these outbreaks, we conducted phylogenetic analysis of viruses isolated from human samples. A total of 23 DENV-1 and DENV-2 sequences were characterized. These analyses signaled that DENV-1 genotype V and DENV-2 American/Asian genotype were circulating in those outbreaks. Our results suggest that the 2007 and 2013 outbreak viral strains of DENV-1 and DENV-2 originated from nearby countries and underwent in situ microevolution. © The American Society of Tropical Medicine and Hygiene.

Pine Defensive Monoterpene α-Pinene Influences the Feeding Behavior of Dendroctonus valens and Its Gut Bacterial Community Structure

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Letian Xu

2016-11-01

Full Text Available The exposure to plant defense chemicals has negative effects on insect feeding activity and modifies insect gut microbial community composition. Dendroctonus valens is a very destructive forest pest in China, and harbors a large diversity and abundance of gut microorganisms. Host pine defensive chemicals can protect the pines from attack by the holobiont. In this study, boring length of D. valens feeding on 0 mg/g α-pinene and 9 mg/g α-pinene concentration in phloem media for 6 and 48 h were recorded, and their gut bacterial communities were analyzed in parallel. Nine milligram per gram α-pinene concentration significantly inhibited boring length of D. valens and altered its gut microbial community structure after 6 h. The inhibition of boring length from 9 mg/g α-pinene in diets ceased after 48 h. No significant differences of the bacterial communities were observed between the beetles in 0 and 9 mg/g α-pinene concentration in phloem media after 48 h. Our results showed that the inhibition of the feeding behavior of D. valens and the disturbance to its gut bacterial communities in 9 mg/g α-pinene concentration in phloem media after 6 h were eliminated after 48 h. The resilience of gut bacterial community of D. valens may help the beetle catabolize pine defense chemical.

An isolated outbreak of diphtheria in South Africa, 2015.

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Mahomed, S; Archary, M; Mutevedzi, P; Mahabeer, Y; Govender, P; Ntshoe, G; Kuhn, W; Thomas, J; Olowolagba, A; Blumberg, L; McCarthy, K; Mlisana, K; DU Plessis, M; VON Gottberg, A; Moodley, P

2017-07-01

An outbreak of respiratory diphtheria occurred in two health districts in the province of KwaZulu-Natal in South Africa in 2015. A multidisciplinary outbreak response team was involved in the investigation and management of the outbreak. Fifteen cases of diphtheria were identified, with ages ranging from 4 to 41 years. Of the 12 cases that were under the age of 18 years, 9 (75%) were not fully immunized for diphtheria. The case fatality was 27%. Ninety-three household contacts, 981 school or work contacts and 595 healthcare worker contacts were identified and given prophylaxis against Corynebacterium diphtheriae infection. A targeted vaccination campaign for children aged 6-15 years was carried out at schools in the two districts. The outbreak highlighted the need to improve diphtheria vaccination coverage in the province and to investigate the feasibility of offering diphtheria vaccines to healthcare workers.

Longevity and fecundity of Dichroplus maculipennis (Orthoptera, Acrididae at non-outbreaking and outbreaking situations Longevidade e fecundidade de Dichroplus maculipennis (Orthoptera: Acrididae: Melanoplinae em situações de "non-outbreaking" e "outbreaking"

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Yanina Mariottini

2011-09-01

Full Text Available Dichroplus maculipennis is one of the most characteristic and damaging grasshopper species of Argentina, mainly in areas of the Pampas and Patagonia regions. We estimated and compared the longevity and fecundity of adult female D. maculipennis under controlled conditions (30ºC, 14L:10D, 40% RH from individuals collected as last instar nymphs (VI in the field and with a known recent history of low and high density conditions. Densities of D. maculipennis at the collecting sites were 0.95 individuals per m² in 2006 and 46 ind/m² in 2009, representing non-outbreaking and outbreaking situations, respectively. Adult female longevity in 2006 (67.96 ± 3.2 days was significantly higher (p 0.05. The fecundity curves showed that the highest values were at weeks 11 and 13 for the 2006 females, and at week 6 for those of 2009. Since the daily oviposition rate at low and high densities was not significantly different, the diminished fecundity rate at high density is attributable to their reduced longevity.O gafanhoto Dichroplus maculipennis é um dos mais característicos e prejudiciales da Argentina, principalmente nas regiões das Pampas e da Patagonia. O objetivo deste estudo foi estimar e comparar a longevidade e fecundidade das fêmeas adultas do D. maculipennis sob condições controladas (30ºC, 14 luz: 10 obscuridad, 40% RH a partir do indivíduos coletados em campo como ultimo estadio ninfal (VI e con historia recente conocida de baixas e altas densidades. As densidades de D. maculipennis nos locais de coleta foram de 0.95 indivíduos por m² em 2006 e 46 indivíduos/m² em 2009, representando situações de "non-outbreaking" e "outbreaking", respectivamente. A longevidade das fêmeas adultas em 2006 (67.96 ± 3.2 dias foi significamente maior (p 0.05. No entanto, as baixas taxas de fecundidade das fêmeas em densidades elevadas, se devem, provavelmente à longevidade reduzida.

Measles outbreak response decision-making under uncertainty: a retrospective analysis.

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Fonnesbeck, Christopher J; Shea, Katriona; Carran, Spencer; Cassio de Moraes, Jose; Gregory, Christopher; Goodson, James L; Ferrari, Matthew J

2018-03-01

Resurgent outbreaks of vaccine-preventable diseases that have previously been controlled or eliminated have been observed in many settings. Reactive vaccination campaigns may successfully control outbreaks but must necessarily be implemented in the face of considerable uncertainty. Real-time surveillance may provide critical information about at-risk population and optimal vaccination targets, but may itself be limited by the specificity of disease confirmation. We propose an integrated modelling approach that synthesizes historical demographic and vaccination data with real-time outbreak surveillance via a dynamic transmission model and an age-specific disease confirmation model. We apply this framework to data from the 1996-1997 measles outbreak in São Paulo, Brazil. To simulate the information available to decision-makers, we truncated the surveillance data to what would have been available at 1 or 2 months prior to the realized interventions. We use the model, fitted to real-time observations, to evaluate the likelihood that candidate age-targeted interventions could control the outbreak. Using only data available prior to the interventions, we estimate that a significant excess of susceptible adults would prevent child-targeted campaigns from controlling the outbreak and that failing to account for age-specific confirmation rates would underestimate the importance of adult-targeted vaccination. © 2018 The Author(s).

An outbreak of enterotoxigenic Escherichia coli (ETEC) infection in Norway, 2012: a reminder to consider uncommon pathogens in outbreaks involving imported products.

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MacDonald, E; Møller, K E; Wester, A L; Dahle, U R; Hermansen, N O; Jenum, P A; Thoresen, L; Vold, L

2015-02-01

We investigated an outbreak of gastroenteritis following a Christmas buffet served on 4-9 December 2012 to ~1300 hotel guests. More than 300 people were reported ill in initial interviews with hotel guests. To identify possible sources of infection we conducted a cohort investigation through which we identified 214 probable cases. Illness was associated with consumption of scrambled eggs (odds ratio 9·07, 95% confidence interval 5·20-15·84). Imported chives added fresh to the scrambled eggs were the suspected source of the outbreak but were unavailable for testing. Enterotoxigenic Escherichia coli (ETEC) infection was eventually confirmed in 40 hotel guests. This outbreak reinforces that ETEC should be considered in non-endemic countries when the clinical picture is consistent and common gastrointestinal pathogens are not found. Following this outbreak, the Norwegian Food Safety Authority recommended that imported fresh herbs should be heat-treated before use in commercial kitchens.

A Methanol Intoxication Outbreak From Recreational Ingestion of Fracking Fluid.

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Collister, David; Duff, Graham; Palatnick, Wesley; Komenda, Paul; Tangri, Navdeep; Hingwala, Jay

2017-05-01

Single-patient methanol intoxications are a common clinical presentation, but outbreaks are rare and usually occur in settings in which there is limited access to ethanol and methanol is consumed as a substitute. In this case report, we describe an outbreak of methanol intoxications that was challenging from a public health perspective and discuss strategies for managing such an outbreak. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Characteristics of wild polio virus outbreak investigation and response in Ethiopia in 2013-2014: implications for prevention of outbreaks due to importations.

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Tegegne, Ayesheshem Ademe; Braka, Fiona; Shebeshi, Meseret Eshetu; Aregay, Aron Kassahun; Beyene, Berhane; Mersha, Amare Mengistu; Ademe, Mohammed; Muhyadin, Abdulahi; Jima, Dadi; Wyessa, Abyot Bekele

2018-01-05

Ethiopia joined the Global Polio Eradication Initiative (GPEI) in 1996, and by the end of December 2001 circulation of indigenous Wild Polio Virus (WPV) had been interrupted. Nonetheless, the country experienced multiple importations during 2004-2008, and in 2013. We characterize the 2013 outbreak investigations and response activities, and document lessons learned. The data were pulled from different field investigation reports and from the national surveillance database for Acute Flaccid Paralysis (AFP). In 2013, a WPV1 outbreak was confirmed following importation in Dollo zone of the Somali region, which affected three Woredas (Warder, Geladi and Bokh). Between July 10, 2013, and January 5, 2014, there were 10 children paralyzed due to WPV1 infection. The majorities (7 of 10) were male and below 5 years of age, and 7 of 10 cases was not vaccinated, and 72% (92/129) of < 5 years of old children living in close proximity with WPV cases had zero doses of oral polio vaccine (OPV). The travel history of the cases showed that seven of the 10 cases had contact with someone who had traveled or had a travel history prior to the onset of paralysis. Underserved and inaccessibility of routine immunization service, suboptimal surveillance sensitivity, poor quality and inadequate supplemental immunization were the most crucial gaps identified during the outbreak investigations. Prior to the 2013 outbreak, Ethiopia experienced multiple imported polio outbreaks following the interruption of indigenous WPV in December 2001. The 2013 outbreak erupted due to massive population movement and was fueled by low population immunity as a result of low routine immunization and supplemental Immunization coverage and quality. In order to avert future outbreaks, it is critical that surveillance sensitivity be improved by establishing community-based surveillance systems and by assigning surveillance focal points at all level particularly in border areas. In addition, it is vital to set

Climate teleconnections and recent patterns of human and animal disease outbreaks.

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Assaf Anyamba

2012-01-01

Full Text Available Recent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Although Rift Valley fever outbreaks have been known to follow periods of above-normal rainfall, the timing of the outbreak events has largely been unknown. Similarly, there is inadequate knowledge on climate drivers of chikungunya outbreaks. We analyze a variety of climate and satellite-derived vegetation measurements to explain the coupling between patterns of climate variability and disease outbreaks of Rift Valley fever and chikungunya.We derived a teleconnections map by correlating long-term monthly global precipitation data with the NINO3.4 sea surface temperature (SST anomaly index. This map identifies regional hot-spots where rainfall variability may have an influence on the ecology of vector borne disease. Among the regions are Eastern and Southern Africa where outbreaks of chikungunya and Rift Valley fever occurred 2004-2009. Chikungunya and Rift Valley fever case locations were mapped to corresponding climate data anomalies to understand associations between specific anomaly patterns in ecological and climate variables and disease outbreak patterns through space and time. From these maps we explored associations among Rift Valley fever disease occurrence locations and cumulative rainfall and vegetation index anomalies. We illustrated the time lag between the driving climate conditions and the timing of the first case of Rift Valley fever. Results showed that reported outbreaks of Rift Valley fever occurred after ∼3-4 months of sustained above-normal rainfall and associated green-up in vegetation, conditions ideal for Rift Valley fever mosquito vectors. For chikungunya we explored associations among surface air temperature, precipitation anomalies, and chikungunya outbreak locations. We found

GHOST: global hepatitis outbreak and surveillance technology.

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Longmire, Atkinson G; Sims, Seth; Rytsareva, Inna; Campo, David S; Skums, Pavel; Dimitrova, Zoya; Ramachandran, Sumathi; Medrzycki, Magdalena; Thai, Hong; Ganova-Raeva, Lilia; Lin, Yulin; Punkova, Lili T; Sue, Amanda; Mirabito, Massimo; Wang, Silver; Tracy, Robin; Bolet, Victor; Sukalac, Thom; Lynberg, Chris; Khudyakov, Yury

2017-12-06

Hepatitis C is a major public health problem in the United States and worldwide. Outbreaks of hepatitis C virus (HCV) infections associated with unsafe injection practices, drug diversion, and other exposures to blood are difficult to detect and investigate. Effective HCV outbreak investigation requires comprehensive surveillance and robust case investigation. We previously developed and validated a methodology for the rapid and cost-effective identification of HCV transmission clusters. Global Hepatitis Outbreak and Surveillance Technology (GHOST) is a cloud-based system enabling users, regardless of computational expertise, to analyze and visualize transmission clusters in an independent, accurate and reproducible way. We present and explore performance of several GHOST implemented algorithms using next-generation sequencing data experimentally obtained from hypervariable region 1 of genetically related and unrelated HCV strains. GHOST processes data from an entire MiSeq run in approximately 3 h. A panel of seven specimens was used for preparation of six repeats of MiSeq libraries. Testing sequence data from these libraries by GHOST showed a consistent transmission linkage detection, testifying to high reproducibility of the system. Lack of linkage among genetically unrelated HCV strains and constant detection of genetic linkage between HCV strains from known transmission pairs and from follow-up specimens at different levels of MiSeq-read sampling indicate high specificity and sensitivity of GHOST in accurate detection of HCV transmission. GHOST enables automatic extraction of timely and relevant public health information suitable for guiding effective intervention measures. It is designed as a virtual diagnostic system intended for use in molecular surveillance and outbreak investigations rather than in research. The system produces accurate and reproducible information on HCV transmission clusters for all users, irrespective of their level of bioinformatics

Giardiasis in Bergen. Outbreak and clinical consequences.

OpenAIRE

Wensaas, Knut-Arne

2011-01-01

Background Giardia lamblia is a common cause of waterborne disease. It is endemic in many parts of the world, especially where sanitation is poor, but in Europe and North America it is most often encountered in outbreaks following contamination of drinking water. The first registered outbreak of giardiasis affecting a large community in Norway happened in Bergen in the autumn of 2004. The reservoir “Svartediket” was the source, and the water probably held Giardia cysts for s...

An Outbreak of Sheep Pox in Zabajkalskij kray of Russia.

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Maksyutov, R A; Gavrilova, E V; Agafonov, A P; Taranov, O S; Glotov, A G; Miheev, V N; Shchelkunov, S N; Sergeev, A N

2015-08-01

In this study, we investigated recent sheep pox outbreaks that occurred in Ononsky and Borzunsky regions of Zabajkalskij kray of Russia. The outbreaks involved in 2756 animals of which 112 were infected and 3 were slaughtered. Samples of injured skin of infected sheep were analysed by electron microscopy and CaPV-specific P32 gene amplification. Following sequence analysis of entire P32 gene showed that both specimens were identical to the sequence of several sheep poxvirus isolates from China and India. The close location of China to the last decade's Russian outbreaks suggest that possible future outbreaks in Russia could occur along the border regions with countries where sheep and goat pox are not controlled. © 2013 Blackwell Verlag GmbH.

Hydrogen outbreak of Zirconium Molybdate Hihydrate

International Nuclear Information System (INIS)

Miura, Yasuhiko; Fukuda, Kazuhiro; Ochi, Eiji

2008-01-01

JNFL is planning to construct a facility for enclosing the hull and end pieces produced due to reprocessing of spent fuel into stainless canisters after compressing, while those hull and end pieces enclosed into the stainless canisters are called 'compressed hulls'. Since the compressed hulls contain moisture absorbent Zirconium Molybdate Hihydrate accompanying hull and end pieces, there is a risk of outbreak of radiolysisradiolysis gas such as hydrogen, etc. by radiolysisradiolysis. This report intends to state the result of radiation irradiation experiment with the purpose of examining the volume of hydrogen outbreak from Zirconium Molybdate Hihydrate of the compressed hulls. (author)

Landscape Epidemiology of Tularemia Outbreaks in Sweden

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Svensson, Kerstin; Bäck, Erik; Eliasson, Henrik; Berglund, Lennart; Granberg, Malin; Karlsson, Linda; Larsson, Pär; Forsman, Mats

2009-01-01

Summer outbreaks of tularemia that occurred from 1995 through 2005 in 2 locations in Sweden affected 441 persons. We performed an epidemiologic investigation of these outbreaks using a novel strategy, involving high-resolution genotyping of Francisella tularensis isolates obtained from 136 patients (using 18 genetic markers developed from 6 F. tularensis genome sequences) and interviews with the patients. Strong spatial associations were found between F. tularensis subpopulations and the places of disease transmission; infection by some subpopulations occurred within areas as small as 2 km2, indicating unidentified environmental point sources of tularemia. In both locations, disease clusters were associated with recreational areas beside water, and genetic subpopulations were present throughout the tularemia season and persisted over years. High-resolution genotyping in combination with patients’ statements about geographic places of disease transmission provided valuable indications of likely sources of infection and the causal genotypes during these tularemia outbreaks. PMID:19961673

Cholera Outbreaks in Urban Bangladesh In 2011.

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Haque, Farhana; Hossain, M Jahangir; Kundu, Subodh Kumar; Naser, Abu Mohd; Rahman, Mahmudur; Luby, Stephen P

In 2011, a multidisciplinary team investigated two diarrhoea outbreaks affecting urban Bangladeshi communities from the districts of Bogra and Kishorganj to identify etiology, pathways of transmission, and factors contributing to these outbreaks. We defined case-patients with severe diarrhoea as residents from affected communities admitted with ≥3 loose stools per day. We listed case-patients, interviewed and examined them, and collected rectal swabs. We visited the affected communities to explore the water and sanitation infrastructure. We tested the microbial load of water samples from selected case household taps, tube wells, and pump stations. We conducted anthropological investigations to understand community perceptions regarding the outbreaks. We identified 21 case-patients from Bogra and 84 from Kishorganj. The median age in Bogra was 23 years, and 21 years in Kishorganj. There were no reported deaths. We isolated Vibrio in 29% (5/17) of rectal swabs from Bogra and in 40% (8/20) from Kishorganj. We found Vibrio in 1/8 tap water samples from Bogra and in both of the samples from Kishorganj. We did not find Vibrio in water samples from pumps or tube wells in either outbreak. Ground water extracted through deep tube wells was supplied intermittently through interconnected pipes without treatment in both areas. We found leakages in the water pipes in Bogra, and in Kishorganj water pipes passed through open sewers. The rapid onset of severe diarrhoea predominantly affecting adults and the isolation of cholera in rectal swabs confirmed that these outbreaks were caused by Vibrio cholerae . The detection of Vibrio in water samples organisms from taps but not from pumps or tube wells, suggested contamination within the pipes. Safe water provision is difficult in municipalities where supply is intermittent, and where pipes commonly leak. Research to develop and evaluate water purification strategies could identify appropriate approaches for ensuring safe drinking

Influenza outbreak during Sydney World Youth Day 2008: the utility of laboratory testing and case definitions on mass gathering outbreak containment.

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Sebastiaan J van Hal

Full Text Available BACKGROUND: Influenza causes annual epidemics and often results in extensive outbreaks in closed communities. To minimize transmission, a range of interventions have been suggested. For these to be effective, an accurate and timely diagnosis of influenza is required. This is confirmed by a positive laboratory test result in an individual whose symptoms are consistent with a predefined clinical case definition. However, the utility of these clinical case definitions and laboratory testing in mass gathering outbreaks remains unknown. METHODS AND RESULTS: An influenza outbreak was identified during World Youth Day 2008 in Sydney. From the data collected on pilgrims presenting to a single clinic, a Markov model was developed and validated against the actual epidemic curve. Simulations were performed to examine the utility of different clinical case definitions and laboratory testing strategies for containment of influenza outbreaks. Clinical case definitions were found to have the greatest impact on averting further cases with no added benefit when combined with any laboratory test. Although nucleic acid testing (NAT demonstrated higher utility than indirect immunofluorescence antigen or on-site point-of-care testing, this effect was lost when laboratory NAT turnaround times was included. The main benefit of laboratory confirmation was limited to identification of true influenza cases amenable to interventions such as antiviral therapy. CONCLUSIONS: Continuous re-evaluation of case definitions and laboratory testing strategies are essential for effective management of influenza outbreaks during mass gatherings.

An outbreak of respiratory tularemia caused by diverse clones of Francisella tularensis.

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Johansson, Anders; Lärkeryd, Adrian; Widerström, Micael; Mörtberg, Sara; Myrtännäs, Kerstin; Ohrman, Caroline; Birdsell, Dawn; Keim, Paul; Wagner, David M; Forsman, Mats; Larsson, Pär

2014-12-01

The bacterium Francisella tularensis is recognized for its virulence, infectivity, genetic homogeneity, and potential as a bioterrorism agent. Outbreaks of respiratory tularemia, caused by inhalation of this bacterium, are poorly understood. Such outbreaks are exceedingly rare, and F. tularensis is seldom recovered from clinical specimens. A localized outbreak of tularemia in Sweden was investigated. Sixty-seven humans contracted laboratory-verified respiratory tularemia. F. tularensis subspecies holarctica was isolated from the blood or pleural fluid of 10 individuals from July to September 2010. Using whole-genome sequencing and analysis of single-nucleotide polymorphisms (SNPs), outbreak isolates were compared with 110 archived global isolates. There were 757 SNPs among the genomes of the 10 outbreak isolates and the 25 most closely related archival isolates (all from Sweden/Finland). Whole genomes of outbreak isolates were >99.9% similar at the nucleotide level and clustered into 3 distinct genetic clades. Unexpectedly, high-sequence similarity grouped some outbreak and archival isolates that originated from patients from different geographic regions and up to 10 years apart. Outbreak and archival genomes frequently differed by only 1-3 of 1 585 229 examined nucleotides. The outbreak was caused by diverse clones of F. tularensis that occurred concomitantly, were widespread, and apparently persisted in the environment. Multiple independent acquisitions of F. tularensis from the environment over a short time period suggest that natural outbreaks of respiratory tularemia are triggered by environmental cues. The findings additionally caution against interpreting genome sequence identity for this pathogen as proof of a direct epidemiological link. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

An outbreak of Salmonella Typhimurium infections in Denmark, Norway and Sweden, 2008.

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Bruun, T; Sørensen, G; Forshell, L P; Jensen, T; Nygard, K; Kapperud, G; Lindstedt, B A; Berglund, T; Wingstrand, A; Petersen, R F; Müller, L; Kjelsø, C; Ivarsson, S; Hjertqvist, M; Löfdahl, S; Ethelberg, S

2009-03-12

In November-December 2008, Norway and Denmark independently identified outbreaks of Salmonella Typhimurium infections characterised in the multiple-locus variable number of tandem repeats analysis (MLVA) by a distinct profile. Outbreak investigations were initiated independently in the two countries. In Denmark, a total of 37 cases were identified, and multiple findings of the outbreak strain in pork and pigs within the same supply chain led to the identification of pork in various forms as the source. In Norway, ten cases were identified, and the outbreak investigation quickly indicated meat bought in Sweden as the probable source and the Swedish authorities were alerted. Investigations in Sweden identified four human cases and two isolates from minced meat with the distinct profile. Subsequent trace-back of the meat showed that it most likely originated from Denmark. Through international alert from Norway on 19 December, it became clear that the Danish and Norwegian outbreak strains were identical and, later on, that the source of the outbreaks in all three countries could be traced back to Danish pork. MLVA was instrumental in linking the outbreaks in the different countries and tracing the source. This outbreak illustrates that good international communication channels, early alerting mechanisms, inter-sectoral collaboration between public health and food safety authorities and harmonised molecular typing tools are important for effective identification and management of cross-border outbreaks. Differences in legal requirements for food safety in neighbouring countries may be a challenge in terms of communication with consumers in areas where cross-border shopping is common.

An outbreak of Burkholderia stabilis colonization in a nasal ward.

Science.gov (United States)

Wang, Lijun; Wang, Mei; Zhang, Junyi; Wu, Wei; Lu, Yuan; Fan, Yanyan

2015-04-01

The aim of this study was to describe an outbreak of Burkholderia stabilis colonization among patients in a nasal ward. Multilocus sequence typing (MLST) was used for the molecular typing of B. stabilis isolates. Microbiological records were reviewed to delineate the colonization outbreak period. One hundred seventy-one cultures of environment and equipment samples from the nasal ward were performed to trace the source of contamination. Infection control measures were taken in order to end the outbreak. All B. stabilis isolates were identified as a new MLST type, ST821. A total of 53 patients carried this B. stabilis in the nasal ward between March and September 2013, which was defined as the outbreak period. The source of the colonization was not determined because all environment cultures were negative for Burkholderia cepacia complex. No further B. stabilis carriers have been found in the ward since the implementation of interventions. Attention must be paid to asymptomatic colonization in order to identify outbreaks early. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Diphtheria outbreak with high mortality in northeastern Nigeria.

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Besa, N C; Coldiron, M E; Bakri, A; Raji, A; Nsuami, M J; Rousseau, C; Hurtado, N; Porten, K

2014-04-01

SUMMARY A diphtheria outbreak occurred from February to November 2011 in the village of Kimba and its surrounding settlements, in Borno State, northeastern Nigeria. We conducted a retrospective outbreak investigation in Kimba village and the surrounding settlements to better describe the extent and clinical characteristics of this outbreak. Ninety-eight cases met the criteria of the case definition of diphtheria, 63 (64.3%) of whom were children aged diphtheria. None of the 98 cases received diphtheria antitoxin, penicillin, or erythromycin during their illness. The overall case-fatality ratio was 21.4%, and was highest in children aged 0-4 years (42.9%). Low rates of immunization, delayed clinical recognition of diphtheria and absence of treatment with antitoxin and appropriate antibiotics contributed to this epidemic and its severity.

A Study of 279 General Outbreaks of Gastrointestinal Infection in the North-East Region of England

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Tebbutt, Grahame M.; Wilson, Deborah; Holtby, Ian

2009-01-01

All outbreaks of infectious intestinal disease reported to the authorities were entered on a computer database with outbreak control teams being established to investigate larger or more significant incidents. The outbreak database and, when set up, the notes of outbreak team meetings were examined for the 279 outbreaks reported in a three-year period (2003–2005). Faeces specimens submitted as part of an outbreak were examined for microbial pathogens and the results cross-matched to the outbreak number. Almost half of the general outbreaks reported (137) occurred in long-term care facilities for the elderly, 51 outbreaks were recorded in hospitals and 31 occurred in the wider community. In 76 outbreaks no specimen was logged. A microbial cause was confirmed in about one-third of outbreaks, with noroviruses being the most common (19%). Salmonellas accounted for 12 of the 21 community outbreaks linked to social events and all were foodborne. Suggestions for improving notification and surveillance are discussed. PMID:19440398

An outbreak of epidemic keratoconjunctivitis at an outpatient ophthalmology clinic

Directory of Open Access Journals (Sweden)

Timothy J Doyle

2010-12-01

Full Text Available Epidemic keratoconjunctivitis (EKC is an acute eye infection caused by adenovirus. We investigated an outbreak of EKC at an outpatient ophthalmology practice in the context of a suspected community wide increase in EKC activity. A site visit was made to the facility reporting the outbreak. A line list was created of patients clinically diagnosed with EKC at the practice during the previous 5 months. A questionnaire was faxed to all other licensed ophthalmologists in the county regarding recent EKC activity in their facility. Descriptive data analyses were conducted. The outbreak facility reported 37 patients clinically diagnosed with EKC during the previous 5 months. In addition, the single ophthalmologist at the practice also had symptoms compatible with EKC during the outbreak period. Specimens were collected on 4 patients and all were positive for adenovirus serotype 8. Forty percent of ophthalmologists surveyed in the county saw at least one EKC patient in the previous 3 months, and 20% reported a perceived increase in EKC activity in recent months over normal seasonal patterns. The outbreak at the facility likely began as part of a widespread community increase in EKC that may have been amplified at the facility through nosocomial transmission. Medical providers experiencing increases in EKC activity above seasonally expected norms should contact their public health department for assistance with etiologic diagnoses and outbreak control.

Outbreaks of gastroenteritis linked to lettuce, Denmark, January 2010

DEFF Research Database (Denmark)

Ethelberg, S.; Lisby, M.; Bottiger, B.

2010-01-01

At least 11 linked outbreaks of gastroenteritis with a total of 260 cases have occurred in Denmark in mid January 2010. Investigations showed that the outbreaks were caused by norovirus of several genotypes and by enterotoxigenic Escherichia coli. Lettuce of the lollo bionda type grown in France...

Mining the key predictors for event outbreaks in social networks

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Yi, Chengqi; Bao, Yuanyuan; Xue, Yibo

2016-04-01

It will be beneficial to devise a method to predict a so-called event outbreak. Existing works mainly focus on exploring effective methods for improving the accuracy of predictions, while ignoring the underlying causes: What makes event go viral? What factors that significantly influence the prediction of an event outbreak in social networks? In this paper, we proposed a novel definition for an event outbreak, taking into account the structural changes to a network during the propagation of content. In addition, we investigated features that were sensitive to predicting an event outbreak. In order to investigate the universality of these features at different stages of an event, we split the entire lifecycle of an event into 20 equal segments according to the proportion of the propagation time. We extracted 44 features, including features related to content, users, structure, and time, from each segment of the event. Based on these features, we proposed a prediction method using supervised classification algorithms to predict event outbreaks. Experimental results indicate that, as time goes by, our method is highly accurate, with a precision rate ranging from 79% to 97% and a recall rate ranging from 74% to 97%. In addition, after applying a feature-selection algorithm, the top five selected features can considerably improve the accuracy of the prediction. Data-driven experimental results show that the entropy of the eigenvector centrality, the entropy of the PageRank, the standard deviation of the betweenness centrality, the proportion of re-shares without content, and the average path length are the key predictors for an event outbreak. Our findings are especially useful for further exploring the intrinsic characteristics of outbreak prediction.

Investigation of outbreaks of Pneumocystis jirovecii pneumonia in two Scottish renal units.

Science.gov (United States)

Inkster, T; Dodd, S; Gunson, R; Imrie, L; Spalding, E; Packer, S; Deighan, C; Daly, C; Coia, J; Imtiaz, T; McGuffie, C; Wilson, R; Bal, A M

2017-06-01

Pneumocystis jirovecii is recognized as an opportunistic pathogen. In recent years, human-to-human transmission of P. jirovecii has been demonstrated. However, outbreaks of P. jirovecii infections are not well defined because the epidemiological setting that facilitates transmission is not fully understood. This article describes two outbreaks of P. jirovecii pneumonia (PCP) in renal transplant patients in the West of Scotland. In total, 25 patients in two geographically contiguous locations were affected. Allele B was identified as the dominant type, along with allele A3. It was not possible to determine the exact reason for clustering of cases, although the outpatient clinic setting featured in one of the outbreaks. The outbreaks ceased with the use of trimethoprim-sulphamethoxazole prophylaxis; the target populations that received prophylaxis were different in the two outbreaks. Infection control teams should be alert to the possibility of outbreaks of PCP. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

A comprehensive database of the geographic spread of past human Ebola outbreaks.

Science.gov (United States)

Mylne, Adrian; Brady, Oliver J; Huang, Zhi; Pigott, David M; Golding, Nick; Kraemer, Moritz U G; Hay, Simon I

2014-01-01

Ebola is a zoonotic filovirus that has the potential to cause outbreaks of variable magnitude in human populations. This database collates our existing knowledge of all known human outbreaks of Ebola for the first time by extracting details of their suspected zoonotic origin and subsequent human-to-human spread from a range of published and non-published sources. In total, 22 unique Ebola outbreaks were identified, composed of 117 unique geographic transmission clusters. Details of the index case and geographic spread of secondary and imported cases were recorded as well as summaries of patient numbers and case fatality rates. A brief text summary describing suspected routes and means of spread for each outbreak was also included. While we cannot yet include the ongoing Guinea and DRC outbreaks until they are over, these data and compiled maps can be used to gain an improved understanding of the initial spread of past Ebola outbreaks and help evaluate surveillance and control guidelines for limiting the spread of future epidemics.

Outbreak of Diarrhetic Shellfish Poisoning Associated with Mussels, British Columbia, Canada

Science.gov (United States)

Taylor, Marsha; McIntyre, Lorraine; Ritson, Mark; Stone, Jason; Bronson, Roni; Bitzikos, Olga; Rourke, Wade; Galanis, Eleni

2013-01-01

In 2011, a Diarrhetic Shellfish Poisoning (DSP) outbreak occurred in British Columbia (BC), Canada that was associated with cooked mussel consumption. This is the first reported DSP outbreak in BC. Investigation of ill individuals, traceback of product and laboratory testing for toxins were used in this investigation. Sixty-two illnesses were reported. Public health and food safety investigation identified a common food source and harvest area. Public health and regulatory agencies took actions to recall product and notify the public. Shellfish monitoring program changes were implemented after the outbreak. Improved response and understanding of toxin production will improve management of future DSP outbreaks. PMID:23697950

An outbreak of food poisoning among children attending an ...

African Journals Online (AJOL)

Objectives. To describe an outbreak of food. poisoning at a major international sports event in Johannesburg and to determine the likely cause and source of the outbreak. Design. A descriptive, case-control study. Setting. An international sports event in Johannesburg. Methods. A questionnaire survey of involved children ...

Molecular Investigation into a Malaria Outbreak in Cusco, Peru: Plasmodium falciparum BV1 Lineage is Linked to a Second Outbreak in Recent Times

Science.gov (United States)

Okoth, Sheila Akinyi; Chenet, Stella M.; Arrospide, Nancy; Gutierrez, Sonia; Cabezas, Cesar; Matta, Jose Antonio; Udhayakumar, Venkatachalam

2016-01-01

In November 2013, a Plasmodium falciparum malaria outbreak of 11 cases occurred in Cusco, southern Peru, where falciparum malaria had not been reported since 1946. Although initial microscopic diagnosis reported only Plasmodium vivax infection in each of the specimens, subsequent examination by the national reference laboratory confirmed P. falciparum infection in all samples. Molecular typing of four available isolates revealed identity as the B-variant (BV1) strain that was responsible for a malaria outbreak in Tumbes, northern Peru, between 2010 and 2012. The P. falciparum BV1 strain is multidrug resistant, can escape detection by PfHRP2-based rapid diagnostic tests, and has contributed to two malaria outbreaks in Peru. This investigation highlights the importance of accurate species diagnosis given the potential for P. falciparum to be reintroduced to regions where it may have been absent. Similar molecular epidemiological investigations can track the probable source(s) of outbreak parasite strains for malaria surveillance and control purposes. PMID:26483121

Polio outbreak investigation and response in Somalia, 2013.

Science.gov (United States)

Kamadjeu, Raoul; Mahamud, Abdirahman; Webeck, Jenna; Baranyikwa, Marie Therese; Chatterjee, Anirban; Bile, Yassin Nur; Birungi, Julianne; Mbaeyi, Chukwuma; Mulugeta, Abraham

2014-11-01

For >2 decades, conflicts and recurrent natural disasters have maintained Somalia in a chronic humanitarian crisis. For nearly 5 years, 1 million children polio once again. A case of acute flaccid paralysis (AFP) was defined as a child Polio cases were defined as AFP cases with stool specimens positive for WPV. From 9 May to 31 December 2013, 189 cases of WPV type 1 (WPV1) were reported from 46 districts of Somalia; 42% were from Banadir region (Mogadishu), 60% were males, and 93% were polio cases belonged to cluster N5A, which is known to have been circulating in northern Nigeria since 2011. In response to the outbreak, 8 supplementary immunization activities were conducted with oral polio vaccine (OPV; trivalent OPV was used initially, followed subsequently by bivalent OPV) targeting various age groups, including children aged polio outbreak erupted after a polio-free period of >6 years (the last case was reported in March 2007). Somalia interrupted indigenous WPV transmission in 2002, was removed from the list of polio-endemic countries a year later, and has since demonstrated its ability to control polio outbreaks resulting from importation. This outbreak reiterates that the threat of large polio outbreaks resulting from WPV importation will remain constant unless polio transmission is interrupted in the remaining polio-endemic countries. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Outbreaks following wild poliovirus importations --- Europe, Africa, and Asia, January 2009-September 2010.

Science.gov (United States)

2010-11-05

The Global Polio Eradication Initiative (GPEI) began in 1988. By 2006, indigenous transmission of wild poliovirus (WPV) had been interrupted in all but four countries (Afghanistan, India, Nigeria, and Pakistan). However, outbreaks following WPV importations into previously polio-free countries remain an ongoing risk until polio is eradicated. The GPEI Strategic Plan for 2010-2012 set the following two goals for outbreak control: 1) end outbreaks occurring in 2009 by mid-2010 and 2) end outbreaks occurring during 2010 to mid-2012 within 6 months of confirmation. This report describes new outbreaks that have occurred in the World Health Organization (WHO) European Region and updates previous reports on the status of outbreaks in Africa and Asia. In 2010, the first WPV importation into the European Region since the region was declared polio-free in 2002 resulted in 476 confirmed cases: 458 in Tajikistan, 14 in Russia, three in Turkmenistan, and one in Kazakhstan. In Africa and Asia, 11 new importations into six countries were observed in 2010; 30 WPV importations that occurred during 2008-2009 resulted in 215 cases in 15 African countries during 2009-2010. An outbreak is considered interrupted if 6 months have elapsed since the latest confirmed case and surveillance performance indicators meet WHO standards. All 2009 outbreaks in Africa appear to have been interrupted, and 2010 outbreaks in three countries appear to have been interrupted. Maintaining high routine vaccination coverage and sensitive surveillance at all times and rapidly instituting additional immunization programs to control outbreaks are key to limiting and stopping the spread of WPV.

Genomic epidemiology of the Escherichia coli O104:H4 outbreaks in Europe, 2011

DEFF Research Database (Denmark)

Grad, Yonatan H; Lipsitch, Marc; Feldgarden, Michael

2012-01-01

The degree to which molecular epidemiology reveals information about the sources and transmission patterns of an outbreak depends on the resolution of the technology used and the samples studied. Isolates of Escherichia coli O104:H4 from the outbreak centered in Germany in May-July 2011, and the ...... that purged diversity in the German isolates, variation in mutation rates in the two E. coli outbreak populations, or uneven distribution of diversity in the seed populations that led to each outbreak....... remarkably little diversity, with only two single nucleotide polymorphisms (SNPs) found in isolates from four individuals. Surprisingly, we found much greater diversity (19 SNPs) in isolates from seven individuals infected in the French outbreak. The German isolates form a clade within the more diverse...... French outbreak strains. Moreover, five isolates derived from a single infected individual from the French outbreak had extremely limited diversity. The striking difference in diversity between the German and French outbreak samples is consistent with several hypotheses, including a bottleneck...

Reported waterborne outbreaks of gastrointestinal disease in Australia are predominantly associated with recreational exposure.

Science.gov (United States)

Dale, Katie; Kirk, Martyn; Sinclair, Martha; Hall, Robert; Leder, Karin

2010-10-01

To examine the frequency and circumstances of reported waterborne outbreaks of gastroenteritis in Australia. Examination of data reported to OzFoodNet between 2001 and 2007. During these seven years, 6,515 gastroenteritis outbreaks were reported to OzFoodNet, most of which were classified as being transmitted person-to-person or from an unknown source. Fifty-four (0.83%) outbreaks were classified as either 'waterborne' or 'suspected waterborne', of which 78% (42/54) were attributed to recreational water and 19% (10/54) to drinking water. Of the drinking water outbreaks, implicated pathogens were found on all but one occasion and included Salmonella sp. (five outbreaks), Campylobacter jejuni (three outbreaks) and Giardia (one outbreak). There have been few waterborne outbreaks detected in Australia, and most of those reported have been associated with recreational exposure. However, there are difficulties in identifying and categorising gastroenteritis outbreaks, as well as in obtaining microbiological and epidemiological evidence, which can result in misclassification or underestimation of water-associated events. Gastroenteritis surveillance data show that, among reported water-associated gastroenteritis outbreaks in Australia, recreational exposure is currently more common than a drinking water source. However, ongoing surveillance for waterborne outbreaks is important, especially as drought conditions may necessitate replacement of conventional drinking water supplies with alternative water sources, which could incur potential for new health risks. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Outbreak of Vibrio parahaemolyticus Sequence Type 120, Peru, 2009.

Science.gov (United States)

Gonzalez-Escalona, Narjol; Gavilan, Ronnie G; Toro, Magaly; Zamudio, Maria L; Martinez-Urtaza, Jaime

2016-07-01

In 2009, an outbreak of Vibrio parahaemolyticus occurred in Piura, Cajamarca, Lambayeque, and Lima, Peru. Whole-genome sequencing of clinical and environmental samples from the outbreak revealed a new V. parahaemolyticus clone. All the isolates identified belonged to a single clonal complex described exclusively in Asia before its emergence in Peru.

Additional value of typing Noroviruses in gastroenteritis outbreaks in Amsterdam, The Netherlands

NARCIS (Netherlands)

Koek, A. G.; Bovée, L. P. M. J.; van den Hoek, J. A. R.; Bos, A. J.; Bruisten, S. M.

2006-01-01

In Amsterdam, 17 of the 55 gastroenteritis (GI) outbreaks reported from January 2002 to May 2003 were confirmed to be caused by noroviruses (NV). In this study, we describe the molecular epidemiology of a group of nine outbreaks associated with a catering firm and two outbreaks, 5 months apart, in

Analysis of epidemiological data of foodborne outbreak reported in Iran

Directory of Open Access Journals (Sweden)

Mohammad Mehdi Soltan Dallal

2015-02-01

Conclusion: The knowledge of bacterial agent of foodborne diseases and determination of antimicrobial resistance pattern are helpful to reduce the rate of foodborne outbreaks, the cost of treatment. The prevention control of outbreaks is also very important.

Assessment of the response to cholera outbreaks in two districts in Ghana.

Science.gov (United States)

Ohene, Sally-Ann; Klenyuie, Wisdom; Sarpeh, Mark

2016-11-02

Despite recurring outbreaks of cholera in Ghana, very little has been reported on assessments of outbreak response activities undertaken in affected areas. This study assessed the response activities undertaken in two districts, Akatsi District in Volta Region and Komenda-Edina-Eguafo-Abirem (KEEA) Municipal in Central Region during the 2012 cholera epidemic in Ghana. We conducted a retrospective assessment of the events, strengths and weaknesses of the cholera outbreak response activities in the two districts making use of the WHO cholera evaluation tool. Information sources included surveillance and facility records, reports and interviews with relevant health personnel involved in the outbreak response from both district health directorates and health facilities. We collected data on age, sex, area of residence, date of reporting to health facility of cholera cases, district population data and information on the outbreak response activities and performed descriptive analyses of the outbreak data by person, time and place. The cholera outbreak in Akatsi was explosive with a high attack rate (AR) of 374/100,000 and case fatality rate (CFR) of 1.2 % while that in KEEA was on a relatively smaller scale AR of 23/100,000 but with a high case fatality rate of 18.8 %. For both districts, we identified multiple strengths in the response to the outbreak including timely notification of the district health officials which triggered prompt investigation of the suspected outbreak facilitating confirmation of cholera and initiation of public health response activities. Others were coordination of the activities by multi-sectoral committees, instituting water, sanitation and hygiene measures and appropriate case management at health facilities. We also found areas that needed improvement in both districts including incomplete surveillance data, sub-optimal community based surveillance considering the late reporting and the deaths in the community and the inadequate

Waterborne norovirus outbreak in a municipal drinking-water supply in Sweden.

Science.gov (United States)

Riera-Montes, M; Brus Sjölander, K; Allestam, G; Hallin, E; Hedlund, K-O; Löfdahl, M

2011-12-01

During Easter 2009, almost 200 people resident in a small Swedish village fell ill with gastrointestinal symptoms. We conducted a retrospective cohort study and a molecular investigation in order to identify the source of the outbreak. Residents living in households connected to the public water network were at an increased risk of developing disease (relative risk 4·80, 95% confidence interval 1·68-13·73) compared to those with no connection to the public network. Norovirus genotype GI.3 was identified in stool samples from six patients and in a sample from the public water network. Contamination of one of the wells supplying the public water network was thought to be the source of the outbreak. This is a description of a norovirus outbreak linked to a municipal drinking-water supply in Sweden. Information from epidemiological and molecular investigations is of utmost importance to guide outbreak control measures and to prevent future outbreaks.

Identification and control of a poliomyelitis outbreak in Xinjiang, China.

Science.gov (United States)

Luo, Hui-Ming; Zhang, Yong; Wang, Xin-Qi; Yu, Wen-Zhou; Wen, Ning; Yan, Dong-Mei; Wang, Hua-Qing; Wushouer, Fuerhati; Wang, Hai-Bo; Xu, Ai-Qiang; Zheng, Jing-Shan; Li, De-Xin; Cui, Hui; Wang, Jian-Ping; Zhu, Shuang-Li; Feng, Zi-Jian; Cui, Fu-Qiang; Ning, Jing; Hao, Li-Xin; Fan, Chun-Xiang; Ning, Gui-Jun; Yu, Hong-Jie; Wang, Shi-Wen; Liu, Da-Wei; Wang, Dong-Yan; Fu, Jian-Ping; Gou, Ai-li; Zhang, Guo-Min; Huang, Guo-Hong; Chen, Yuan-Sheng; Mi, Sha-Sha; Liu, Yan-Min; Yin, Da-Peng; Zhu, Hui; Fan, Xin-Chun; Li, Xin-Lan; Ji, Yi-Xin; Li, Ke-Li; Tang, Hai-Shu; Xu, Wen-Bo; Wang, Yu; Yang, Wei-Zhong

2013-11-21

The last case of infection with wild-type poliovirus indigenous to China was reported in 1994, and China was certified as a poliomyelitis-free region in 2000. In 2011, an outbreak of infection with imported wild-type poliovirus occurred in the province of Xinjiang. We conducted an investigation to guide the response to the outbreak, performed sequence analysis of the poliovirus type 1 capsid protein VP1 to determine the source, and carried out serologic and coverage surveys to assess the risk of viral propagation. Surveillance for acute flaccid paralysis was intensified to enhance case ascertainment. Between July 3 and October 9, 2011, investigators identified 21 cases of infection with wild-type poliovirus and 23 clinically compatible cases in southern Xinjiang. Wild-type poliovirus type 1 was isolated from 14 of 673 contacts of patients with acute flaccid paralysis (2.1%) and from 13 of 491 healthy persons who were not in contact with affected persons (2.6%). Sequence analysis implicated an imported wild-type poliovirus that originated in Pakistan as the cause of the outbreak. A public health emergency was declared in Xinjiang after the outbreak was confirmed. Surveillance for acute flaccid paralysis was enhanced, with daily reporting from all public and private hospitals. Five rounds of vaccination with live, attenuated oral poliovirus vaccine (OPV) were conducted among children and adults, and 43 million doses of OPV were administered. Trivalent OPV was used in three rounds, and monovalent OPV type 1 was used in two rounds. The outbreak was stopped 1.5 months after laboratory confirmation of the index case. The 2011 outbreak in China showed that poliomyelitis-free countries remain at risk for outbreaks while the poliovirus circulates anywhere in the world. Global eradication of poliomyelitis will benefit all countries, even those that are currently free of poliomyelitis.

Clostridium perfringens in London, July 2009: two weddings and an outbreak.

OpenAIRE

Eriksen, J.; Zenner, D.; Anderson, S. R.; Grant, K.; Kumar, D.

2010-01-01

: Food poisoning outbreaks caused by Clostridium perfringens enterotoxin occur occasionally in Europe but have become less common in recent years. This paper presents the microbiological and epidemiological results of a large C. perfringens outbreak occurring simultaneously at two weddings that used the same caterer. The outbreak involved several London locations and required coordination across multiple agencies. A case-control study (n=134) was carried out to analyse possible associations b...

Pertussis outbreak in northwest Ireland, January - June 2010.

LENUS (Irish Health Repository)

Barret, A S

2010-09-02

We report a community pertussis outbreak that occurred in a small town located in the northwest of Ireland. Epidemiological investigations suggest that waning immunity and the absence of a booster dose during the second year of life could have contributed to the outbreak. The report also highlights the need to reinforce the surveillance of pertussis in Ireland and especially to improve the clinical and laboratory diagnosis of cases.

Internet and free press are associated with reduced lags in global outbreak reporting.

Science.gov (United States)

McAlarnen, Lindsey; Smith, Katherine; Brownstein, John S; Jerde, Christopher

2014-10-30

Global outbreak detection and reporting have generally improved for a variety of infectious diseases and geographic regions in recent decades. Nevertheless, lags in outbreak reporting remain a threat to the global human health and economy. In the time between first occurrence of a novel disease incident and public notification of an outbreak, infected individuals have a greater possibility of traveling and spreading the pathogen to other nations. Shortening outbreak reporting lags has the potential to improve global health by preventing local outbreaks from escalating into global epidemics. Reporting lags between the first record and the first public report of an event were calculated for 318 outbreaks occurring 1996-2009. The influence of freedom of the press, Internet usage, per capita health expenditure, and cell phone subscriptions, on the timeliness of outbreak reporting was evaluated. Freer presses and increasing Internet usage correlate with reduced time between the first record of an outbreak and the public report. Increasing Internet usage reduced the expected reporting lag from more than one month in nations without Internet users to one day in those where 75 of 100 people use the Internet. Advances in technology and the emergence of more open and free governments are associated with to improved global infectious disease surveillance.

How Will Climate Change Impact Cholera Outbreaks?

Science.gov (United States)

Nasr Azadani, F.; Jutla, A.; Rahimikolu, J.; Akanda, A. S.; Huq, A.; Colwell, R. R.

2014-12-01

Environmental parameters associated with cholera are well documented. However, cholera continues to be a global public health threat. Uncertainty in defining environmental processes affecting growth and multiplication of the cholera bacteria can be affected significantly by changing climate at different temporal and spatial scales, either through amplification of the hydroclimatic cycle or by enhanced variability of large scale geophysical processes. Endemic cholera in the Bengal Delta region of South Asia has a unique pattern of two seasonal peaks and there are associated with asymmetric and episodic variability in river discharge. The first cholera outbreak in spring is related with intrusion of bacteria laden coastal seawater during low river discharge. Cholera occurring during the fall season is hypothesized to be associated with high river discharge related to a cross-contamination of water resources and, therefore, a second wave of disease, a phenomenon characteristic primarily in the inland regions. Because of difficulties in establishing linkage between coarse resolutions of the Global Climate Model (GCM) output and localized disease outbreaks, the impact of climate change on diarrheal disease has not been explored. Here using the downscaling method of Support Vector Machines from HADCM3 and ECHAM models, we show how cholera outbreak patterns are changing in the Bengal Delta. Our preliminary results indicate statistically significant changes in both seasonality and magnitude in the occurrence of cholera over the next century. Endemic cholera is likely to transform into epidemic forms and new geographical areas will be at risk for cholera outbreaks.

Identification of resistance and virulence factors in an epidemic Enterobacter hormaechei outbreak strain

NARCIS (Netherlands)

Paauw, A.; Caspers, M.P.M.; Leverstein-van Hall, M.A.; Schuren, F.H.J.; Montijn, R.C.; Verhoef, J.; Fluit, A.C.

2009-01-01

Bacterial strains differ in their ability to cause hospital outbreaks. Using comparative genomic hybridization, Enterobacter cloacae complex isolates were studied to identify genetic markers specific for Enterobacter cloacae complex outbreak strains. No outbreak-specific genes were found that were

A comprehensive database of the geographic spread of past human Ebola outbreaks

Science.gov (United States)

Mylne, Adrian; Brady, Oliver J.; Huang, Zhi; Pigott, David M.; Golding, Nick; Kraemer, Moritz U.G.; Hay, Simon I.

2014-01-01

Ebola is a zoonotic filovirus that has the potential to cause outbreaks of variable magnitude in human populations. This database collates our existing knowledge of all known human outbreaks of Ebola for the first time by extracting details of their suspected zoonotic origin and subsequent human-to-human spread from a range of published and non-published sources. In total, 22 unique Ebola outbreaks were identified, composed of 117 unique geographic transmission clusters. Details of the index case and geographic spread of secondary and imported cases were recorded as well as summaries of patient numbers and case fatality rates. A brief text summary describing suspected routes and means of spread for each outbreak was also included. While we cannot yet include the ongoing Guinea and DRC outbreaks until they are over, these data and compiled maps can be used to gain an improved understanding of the initial spread of past Ebola outbreaks and help evaluate surveillance and control guidelines for limiting the spread of future epidemics. PMID:25984346

19th-century and early 20th-century jaundice outbreaks, the USA.

Science.gov (United States)

Teo, C G

2018-01-01

Historical enquiry into diseases with morbidity or mortality predilections for particular demographic groups can permit clarification of their emergence, endemicity, and epidemicity. During community-wide outbreaks of hepatitis A in the pre-vaccine era, clinical attack rates were higher among juveniles rather than adults. In community-wide hepatitis E outbreaks, past and present, mortality rates have been most pronounced among pregnant women. Examination for these characteristic predilections in reports of jaundice outbreaks in the USA traces the emergence of hepatitis A and also of hepatitis E to the closing three decades of the 19th century. Thereafter, outbreaks of hepatitis A burgeoned, whereas those of hepatitis E abated. There were, in addition, community-wide outbreaks that bore features of neither hepatitis A nor E; they occurred before the 1870s. The American Civil War antedated that period. If hepatitis A had yet to establish endemicity, then it would not underlie the jaundice epidemic that was widespread during the war. Such an assessment may be revised, however, with the discovery of more extant outbreak reports.

Population control methods in stochastic extinction and outbreak scenarios.

Directory of Open Access Journals (Sweden)

Juan Segura

Full Text Available Adaptive limiter control (ALC and adaptive threshold harvesting (ATH are two related control methods that have been shown to stabilize fluctuating populations. Large variations in population abundance can threaten the constancy and the persistence stability of ecological populations, which may impede the success and efficiency of managing natural resources. Here, we consider population models that include biological mechanisms characteristic for causing extinctions on the one hand and pest outbreaks on the other hand. These models include Allee effects and the impact of natural enemies (as is typical of forest defoliating insects. We study the impacts of noise and different levels of biological parameters in three extinction and two outbreak scenarios. Our results show that ALC and ATH have an effect on extinction and outbreak risks only for sufficiently large control intensities. Moreover, there is a clear disparity between the two control methods: in the extinction scenarios, ALC can be effective and ATH can be counterproductive, whereas in the outbreak scenarios the situation is reversed, with ATH being effective and ALC being potentially counterproductive.

Population control methods in stochastic extinction and outbreak scenarios.

Science.gov (United States)

Segura, Juan; Hilker, Frank M; Franco, Daniel

2017-01-01

Adaptive limiter control (ALC) and adaptive threshold harvesting (ATH) are two related control methods that have been shown to stabilize fluctuating populations. Large variations in population abundance can threaten the constancy and the persistence stability of ecological populations, which may impede the success and efficiency of managing natural resources. Here, we consider population models that include biological mechanisms characteristic for causing extinctions on the one hand and pest outbreaks on the other hand. These models include Allee effects and the impact of natural enemies (as is typical of forest defoliating insects). We study the impacts of noise and different levels of biological parameters in three extinction and two outbreak scenarios. Our results show that ALC and ATH have an effect on extinction and outbreak risks only for sufficiently large control intensities. Moreover, there is a clear disparity between the two control methods: in the extinction scenarios, ALC can be effective and ATH can be counterproductive, whereas in the outbreak scenarios the situation is reversed, with ATH being effective and ALC being potentially counterproductive.

The legacy of attack: implications of high phloem resin monoterpene levels in lodgepole pines following mass attack by mountain pine beetle, Dendroctonus ponderosae Hopkins.

Science.gov (United States)

Clark, E L; Huber, D P W; Carroll, A L

2012-04-01

The mountain pine beetle (Dendroctonus ponderosae Hopkins) is the most serious pest of pines (Pinus) in western North America. Host pines protect themselves from attack by producing a complex mixture of terpenes in their resin. We sampled lodgepole pine (Pinus contorta variety latifolia) phloem resin at four widely separated locations in the interior of British Columbia, Canada, both just before (beginning of July) and substantially after (end of August) the mountain pine beetle dispersal period. The sampled trees then were observed the next spring for evidence of survival, and the levels of seven resin monoterpenes were compared between July and August samples. Trees that did not survive consistently had significantly higher phloem resin monoterpene levels at the end of August compared with levels in July. Trees that did survive mainly did not exhibit a significant difference between the two sample dates. The accumulation of copious defense-related secondary metabolites in the resin of mountain pine beetle-killed lodgepole pine has important implications for describing the environmental niche that the beetle offspring survive in as well as that of parasitoids, predators, and other associates.

Response to a large rotavirus outbreak on South Tarawa, Kiribati, 2013

Directory of Open Access Journals (Sweden)

Teanibuaka Tabunga

2014-05-01

Full Text Available Introduction: In July 2013, during annual independence celebrations in Kiribati, staff at Tungaru Central Hospital on South Tarawa reported an increase in children presenting with severe diarrhoea. This report describes the outbreak investigation, findings and response. Method: After notification of the outbreak, all health facilities on South Tarawa began reporting cases of acute diarrhoea and/or vomiting through the early warning syndromic surveillance system on a daily basis. Community awareness was raised and the public was encouraged to present to a health facility if ill with acute gastroenteritis. Specimens were collected and sent for laboratory testing. Results: Between 10 and 24 July 2013, 1118 cases of gastroenteritis were reported; 103 were hospitalized and six died. The median age of cases was one year (range: 0–68 years; 93.4% were aged less than five years. Rotavirus was identified in 81% of specimens tested. The outbreak response included enhanced surveillance, community education, clinical training and changes to in-hospital patient management for infection control. Discussion: This outbreak was the largest diarrhoea outbreak in Kiribati in five years. Factors that may have contributed to the magnitude and severity of the outbreak included high household density, inadequate sanitation infrastructure and a mass gathering – all increasing the chance of transmission – as well as limited clinical response capacity. The current outbreak highlights the importance of clinical management to minimize severe dehydration and death. Rotavirus vaccination should be considered as an adjunct to other comprehensive enteric disease control measures as recommended by the World Health Organization.

Major outbreaks of the Douglas-fir tussock moth in Oregon and California.

Science.gov (United States)

Boyd E. Wickman; Richard R. Mason; C.G. Thompson

1973-01-01

Case histories of five tussock moth outbreaks that occurred in California and Oregon between 1935 and 1965 are discussed. Information is given on the size and duration of the outbreaks, the presence of natural control agents and the damage caused. Most of the outbreaks were eventually treated with DDT. However, enough information was available from untreated portions...

Habitat evaluation for outbreak of Yangtze voles (Microtus fortis) and management implications.

Science.gov (United States)

Xu, Zhenggang; Zhao, Yunlin; Li, Bo; Zhang, Meiwen; Shen, Guo; Wang, Yong

2015-05-01

Rodent pests severely damage agricultural crops. Outbreak risk models of rodent pests often do not include sufficient information regarding geographic variation. Habitat plays an important role in rodent-pest outbreak risk, and more information about the relationship between habitat and crop protection is urgently needed. The goal of the present study was to provide an outbreak risk map for the Dongting Lake region and to understand the relationship between rodent-pest outbreak variation and habitat distribution. The main rodent pests in the Dongting Lake region are Yangtze voles (Microtus fortis). These pests cause massive damage in outbreak years, most notably in 2007. Habitat evaluation and ecological details were obtained by analyzing the correlation between habitat suitability and outbreak risk, as indicated by population density and historical events. For the source-sink population, 96.18% of Yangtze vole disaster regions were covered by a 10-km buffer zone of suitable habitat in 2007. Historical outbreak frequency and peak population density were significantly correlated with the proportion of land covered by suitable habitat (r = 0.68, P = 0.04 and r = 0.76, P = 0.03, respectively). The Yangtze vole population tends to migrate approximately 10 km in outbreak years. Here, we propose a practical method for habitat evaluation that can be used to create integrated pest management plans for rodent pests when combined with basic information on the biology, ecology and behavior of the target species. © 2014 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

Rapid control of a chancroid outbreak: implications for Canada.

Science.gov (United States)

Jessamine, P G; Brunham, R C

1990-01-01

From June to November 1987 an outbreak of chancroid occurred in Winnipeg, the first in more than 10 years; 14 people (9 men, 5 women) were involved. Nine of the cases were confirmed through culture. A control strategy was implemented in November 1987 that included presumptive treatment of genital ulcer disease with single-dose antimicrobial therapy, intensive tracing of contacts and treatment of asymptomatic sexual contacts. The origin of the outbreak was not determined, and an epidemiologic link between all the patients could not be demonstrated. The isolates were found to contain the same plasmid; this suggested that a single clone of Haemophilus ducreyi was responsible for the outbreak. Images Fig. 2 PMID:2337844

outbreak of hepatitis 'E' in risalpur garrison

International Nuclear Information System (INIS)

Sharif, T.B.; Tariq, W.U.Z.

2007-01-01

Hepatitis E virus is an RNA virus. It results in epidemics/outbreaks in geographical areas lacking clean water and sanitation. It is excreted in stools and is enterically transmitted (faeco-oral route). The clinical picture resembles other acute hepatitis and diagnosis is clinched by detecting anti-HEV IgM in infected individuals. It is a self-limiting disease and does not progress to chronicity. There is no vaccine available so far, to confer immunity against HEV infection. HEV is endemic in many parts of the world and has resulted in many epidemics / outbreaks worldwide. It is also endemic in Pakistan and epidemics / outbreaks have generally been under reported. To establish the cause of outbreak Blood samples of the patients (n=195), admitted in isolation ward were collected aseptically for routine baseline investigations and hepatitis screening. Separate blood samples were sent to Armed Forces Institute of pathology (AFIP), Rawalpindi for detection of antibodies to hepatitis E virus (Anti HEV IgM). Water samples collected during the outbreak were tested by multiple tube technique. MPN (Most Probable Number) method was used to determine faecal coliform bacteria per 100 ml of water sample. All the patients (n=195) on admission had raised ALT (Alanine Aminotransferase) levels along with hyperbilirubinemia, 37% had raised TLC with polymorphonuclear response. None had HBsAg (Hepatitis B surface antign) or anti-HCV (antibodies to hepatitis C virus), 23% had prolonged PT (Prothrombin Time). Samples despatched to AFIP Rawalpindi confirmed the presence of anti-HEV IgM. Follow up analysis revealed many fold increase in ALT levels. Average stay in the Hospital was 23.6 days per patient. All the water samples were declared unfit for drinking due to high coliform count. At present, no vaccine is available to protect against HEV infection. Mainstay for prevention and occurrence is to formulate cost-effective strategies for improvement of self/environmental hygiene and

Factors determining dengue outbreak in Malaysia.

Science.gov (United States)

Ahmad, Rohani; Suzilah, Ismail; Wan Najdah, Wan Mohamad Ali; Topek, Omar; Mustafakamal, Ibrahim; Lee, Han Lim

2018-01-01

A large scale study was conducted to elucidate the true relationship among entomological, epidemiological and environmental factors that contributed to dengue outbreak in Malaysia. Two large areas (Selayang and Bandar Baru Bangi) were selected in this study based on five consecutive years of high dengue cases. Entomological data were collected using ovitraps where the number of larvae was used to reflect Aedes mosquito population size; followed by RT-PCR screening to detect and serotype dengue virus in mosquitoes. Notified cases, date of disease onset, and number and type of the interventions were used as epidemiological endpoint, while rainfall, temperature, relative humidity and air pollution index (API) were indicators for environmental data. The field study was conducted during 81 weeks of data collection. Correlation and Autoregressive Distributed Lag Model were used to determine the relationship. The study showed that, notified cases were indirectly related with the environmental data, but shifted one week, i.e. last 3 weeks positive PCR; last 4 weeks rainfall; last 3 weeks maximum relative humidity; last 3 weeks minimum and maximum temperature; and last 4 weeks air pollution index (API), respectively. Notified cases were also related with next week intervention, while conventional intervention only happened 4 weeks after larvae were found, indicating ample time for dengue transmission. Based on a significant relationship among the three factors (epidemiological, entomological and environmental), estimated Autoregressive Distributed Lag (ADL) model for both locations produced high accuracy 84.9% for Selayang and 84.1% for Bandar Baru Bangi in predicting the actual notified cases. Hence, such model can be used in forestalling dengue outbreak and acts as an early warning system. The existence of relationships among the entomological, epidemiological and environmental factors can be used to build an early warning system for the prediction of dengue outbreak so

Large outbreaks of Salmonella Typhimurium infection in Denmark in 2008

DEFF Research Database (Denmark)

Ethelberg, S.; Wingstrand, Anne; Jensen, T.

2008-01-01

An outbreak of Salmonella Typhimurium phage type U292 has been ongoing in Denmark since 1 April, with 1,054 cases registered until 23 October 2008. Extensive investigations including hypothesis-generating interviews, matched case-control studies, cohort studies in embedded outbreaks, shopping list...

Measles Cases during Ebola Outbreak, West Africa, 2013-2106.

Science.gov (United States)

Colavita, Francesca; Biava, Mirella; Castilletti, Concetta; Quartu, Serena; Vairo, Francesco; Caglioti, Claudia; Agrati, Chiara; Lalle, Eleonora; Bordi, Licia; Lanini, Simone; Guanti, Michela Delli; Miccio, Rossella; Ippolito, Giuseppe; Capobianchi, Maria R; Di Caro, Antonino

2017-06-01

The recent Ebola outbreak in West Africa caused breakdowns in public health systems, which might have caused outbreaks of vaccine-preventable diseases. We tested 80 patients admitted to an Ebola treatment center in Freetown, Sierra Leone, for measles. These patients were negative for Ebola virus. Measles virus IgM was detected in 13 (16%) of the patients.

A review of outbreaks of waterborne disease associated with ships: evidence for risk management.

Science.gov (United States)

Rooney, Roisin M; Bartram, Jamie K; Cramer, Elaine H; Mantha, Stacey; Nichols, Gordon; Suraj, Rohini; Todd, Ewen C D

2004-01-01

The organization of water supply to and on ships differs considerably from that of water supply on land. Risks of contamination can arise from source water at the port or during loading, storage, or distribution on the ship. The purpose of this article is to review documented outbreaks of waterborne diseases associated with passenger, cargo, fishing, and naval ships to identify contributing factors so that similar outbreaks can be prevented in the future. The authors reviewed 21 reported outbreaks of waterborne diseases associated with ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and remedial action are presented. The findings of this review show that the majority of reported outbreaks were associated with passenger ships and that more than 6,400 people were affected. Waterborne outbreaks due to Enterotoxigenic Escherichia coli, noroviruses, Salmonella spp, Shigella sp, Cryptosporidium sp, and Giardia lamblia occurred on ships. Enterotoxigenic E. coli was the pathogen most frequently associated with outbreaks. One outbreak of chemical water poisoning also occurred on a ship. Risk factors included contaminated port water, inadequate treatment, improper loading techniques, poor design and maintenance of storage tanks, ingress of contamination during repair and maintenance, cross-connections, back siphonage, and insufficient residual disinfectant. Waterborne disease outbreaks on ships can be prevented. The factors contributing to outbreaks emphasize the need for hygienic handling of water along the supply chain from source to consumption. A comprehensive approach to water safety on ships is essential. This may be achieved by the adoption of Water Safety Plans that cover design, construction, operation, and routine inspection and maintenance.

Perspectives on West Africa Ebola Virus Disease Outbreak, 2013-2016.

Science.gov (United States)

Spengler, Jessica R; Ervin, Elizabeth D; Towner, Jonathan S; Rollin, Pierre E; Nichol, Stuart T

2016-06-01

The variety of factors that contributed to the initial undetected spread of Ebola virus disease in West Africa during 2013-2016 and the difficulty controlling the outbreak once the etiology was identified highlight priorities for disease prevention, detection, and response. These factors include occurrence in a region recovering from civil instability and lacking experience with Ebola response; inadequate surveillance, recognition of suspected cases, and Ebola diagnosis; mobile populations and extensive urban transmission; and the community's insufficient general understanding about the disease. The magnitude of the outbreak was not attributable to a substantial change of the virus. Continued efforts during the outbreak and in preparation for future outbreak response should involve identifying the reservoir, improving in-country detection and response capacity, conducting survivor studies and supporting survivors, engaging in culturally appropriate public education and risk communication, building productive interagency relationships, and continuing support for basic research.

Positive impact of infection prevention on the management of nosocomial outbreaks at an academic hospital.

Science.gov (United States)

Dik, Jan-Willem H; Sinha, Bhanu; Lokate, Mariëtte; Lo-Ten-Foe, Jerome R; Dinkelacker, Ariane G; Postma, Maarten J; Friedrich, Alexander W

2016-10-01

Infection prevention (IP) measures are vital to prevent (nosocomial) outbreaks. Financial evaluations of these are scarce. An incremental cost analysis for an academic IP unit was performed. On a yearly basis, we evaluated: IP measures; costs thereof; numbers of patients at risk for causing nosocomial outbreaks; predicted outbreak patients; and actual outbreak patients. IP costs rose on average yearly with €150,000; however, more IP actions were undertaken. Numbers of patients colonized with high-risk microorganisms increased. The trend of actual outbreak patients remained stable. Predicted prevented outbreak patients saved costs, leading to a positive return on investment of 1.94. This study shows that investments in IP can prevent outbreak cases, thereby saving enough money to earn back these investments.

Discovering network behind infectious disease outbreak

Science.gov (United States)

Maeno, Yoshiharu

2010-11-01

Stochasticity and spatial heterogeneity are of great interest recently in studying the spread of an infectious disease. The presented method solves an inverse problem to discover the effectively decisive topology of a heterogeneous network and reveal the transmission parameters which govern the stochastic spreads over the network from a dataset on an infectious disease outbreak in the early growth phase. Populations in a combination of epidemiological compartment models and a meta-population network model are described by stochastic differential equations. Probability density functions are derived from the equations and used for the maximal likelihood estimation of the topology and parameters. The method is tested with computationally synthesized datasets and the WHO dataset on the SARS outbreak.

Statistics of severe tornadoes and severe tornado outbreaks

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B. D. Malamud

2012-09-01

Full Text Available The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider severe tornadoes, which we define as L≥10 km, in the continental USA (USA Storm Prediction Center Severe Weather Database. We find that for the period 1982–2011, for individual severe tornadoes (L≥10 km: (i There is a strong linear scaling between the number of severe tornadoes in a year and their total path length in that year. (ii The cumulative frequency path length data suggests that, not taking into account any changing trends over time, we would expect in a given year (on average one severe tornado with a path length L≥115 km and in a decade (on average one severe tornado with a path length L≥215 km. (iii The noncumulative frequency-length statistics of severe tornado touchdown path lengths, 20<L<200 km, is well approximated by an inverse power-law relationship with exponent near 3. We then take the total path length of severe tornadoes in a convective day (12:00–12:00 UTC, L_D, as a measure of the strength of a 24-h USA tornado outbreak. We find that: (i For 1982–2011, the number of severe tornadoes in a USA convective day outbreak has a strong power-law relationship (exponent 0.80 on the convective day total path length, L_D. (ii For 1952–2011, the cumulative frequency path length data for severe tornado outbreaks suggests that we would expect in a given year (on average one daily severe tornado outbreak with total path length L_D≥480 km and in a decade (on average one daily severe tornado outbreak with a total path length L_D≥1200 km. (iii For 1982–2011, the noncumulative frequency-length statistics of tornado

Dynamics of epidemics outbreaks in heterogeneous populations

Science.gov (United States)

Brockmann, Dirk; Morales-Gallardo, Alejandro; Geisel, Theo

2007-03-01

The dynamics of epidemic outbreaks have been investigated in recent years within two alternative theoretical paradigms. The key parameter of mean field type of models such as the SIR model is the basic reproduction number R0, the average number of secondary infections caused by one infected individual. Recently, scale free network models have received much attention as they account for the high variability in the number of social contacts involved. These models predict an infinite basic reproduction number in some cases. We investigate the impact of heterogeneities of contact rates in a generic model for epidemic outbreaks. We present a system in which both the time periods of being infectious and the time periods between transmissions are Poissonian processes. The heterogeneities are introduced by means of strongly variable contact rates. In contrast to scale free network models we observe a finite basic reproduction number and, counterintuitively a smaller overall epidemic outbreak as compared to the homogeneous system. Our study thus reveals that heterogeneities in contact rates do not necessarily facilitate the spread to infectious disease but may well attenuate it.

Avalanche outbreaks emerging in cooperative contagions

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Cai, Weiran; Chen, Li; Ghanbarnejad, Fakhteh; Grassberger, Peter

2015-11-01

The spreading of contagions can exhibit a percolation transition, which separates transitory prevalence from outbreaks that reach a finite fraction of the population. Such transitions are commonly believed to be continuous, but empirical studies have shown more violent spreading modes when the participating agents are not limited to one type. Striking examples include the co-epidemic of the Spanish flu and pneumonia that occurred in 1918 (refs , ), and, more recently, the concurrent prevalence of HIV/AIDS and a host of diseases. It remains unclear to what extent an outbreak in the presence of interacting pathogens differs from that due to an ordinary single-agent process. Here we study a mechanistic model for understanding contagion processes involving inter-agent cooperation. Our stochastic simulations reveal the possible emergence of a massive avalanche-like outbreak right at the threshold, which is manifested as a discontinuous phase transition. Such an abrupt change arises only if the underlying network topology supports a bottleneck for cascaded mutual infections. Surprisingly, all these discontinuous transitions are accompanied by non-trivial critical behaviours, presenting a rare case of hybrid transition. The findings may imply the origin of catastrophic occurrences in many realistic systems, from co-epidemics to financial contagions.

Cryptosporidiosis outbreaks associated with recreational water use--five states, 2006.

Science.gov (United States)

2007-07-27

Cryptosporidiosis is a gastrointestinal illness caused by parasitic protozoa of the genus Cryptosporidium and can produce watery diarrhea lasting 1-3 weeks; one or two cases per 100,000 population are reported annually in the United States. Fecal-oral transmission of Cryptosporidium oocysts occurs through ingestion of contaminated drinking or recreational water, consumption of contaminated food, and contact with infected persons or animals (e.g., cattle or sheep). Unlike bacterial pathogens, Cryptosporidium oocysts are resistant to chlorine disinfection and can survive for days in treated recreational water venues (e.g., public and residential swimming pools and community and commercial water parks) despite adherence to recommended residual chlorine levels (1-3 ppm). For 2006, a total of 18 cryptosporidiosis outbreaks have been reported (as of July 24, 2007) to CDC's U.S. Waterborne Disease and Outbreak Surveillance System, compared with five outbreaks reported for 2003 and seven for 2004; data for 2005 and 2006 are not yet final. This report describes five laboratory-confirmed cryptosporidiosis outbreaks in 2006 that involved public recreational water use. The popularity of recreational water venues, the number and geographic distribution of recent cryptosporidiosis outbreaks, and the resistance of Cryptosporidium to chlorination suggest that treatment strategies for recreational water facilities need to be improved.

Natural Disasters and Cholera Outbreaks: Current Understanding and Future Outlook.

Science.gov (United States)

Jutla, Antarpreet; Khan, Rakibul; Colwell, Rita

2017-03-01

Diarrheal diseases remain a serious global public health threat, especially for those populations lacking access to safe water and sanitation infrastructure. Although association of several diarrheal diseases, e.g., cholera, shigellosis, etc., with climatic processes has been documented, the global human population remains at heightened risk of outbreak of diseases after natural disasters, such as earthquakes, floods, or droughts. In this review, cholera was selected as a signature diarrheal disease and the role of natural disasters in triggering and transmitting cholera was analyzed. Key observations include identification of an inherent feedback loop that includes societal structure, prevailing climatic processes, and spatio-temporal seasonal variability of natural disasters. Data obtained from satellite-based remote sensing are concluded to have application, although limited, in predicting risks of a cholera outbreak(s). We argue that with the advent of new high spectral and spatial resolution data, earth observation systems should be seamlessly integrated in a decision support mechanism to be mobilize resources when a region suffers a natural disaster. A framework is proposed that can be used to assess the impact of natural disasters with response to outbreak of cholera, providing assessment of short- and long-term influence of climatic processes on disease outbreaks.

Measles (Rubeola) Cases and Outbreaks

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... Address What’s this? Submit What's this? Submit Button Measles Cases and Outbreaks Language: English (US) Español (Spanish) ... Español: Casos y brotes de sarampión Number of measles cases by year since 2010 Measles cases per ...

Multiple origins of outbreak populations of a native insect pest in an agro-ecosystem.

Science.gov (United States)

Kobayashi, T; Sakurai, T; Sakakibara, M; Watanabe, T

2011-06-01

Native insects can become epidemic pests in agro-ecosystems. A population genetics approach was applied to analyze the emergence and spread of outbreak populations of native insect species. Outbreaks of the mirid bug, Stenotus rubrovittatus, have rapidly expanded over Japan within the last two decades. To characterize the outbreak dynamics of this species, the genetic structure of local populations was assessed using polymorphisms of the mtDNA COI gene and six microsatellite loci. Results of the population genetic analysis suggested that S. rubrovittatus populations throughout Japan were genetically isolated by geographic distance and separated into three genetic clusters occupying spatially segregated regions. Phylogeographic analysis indicated that the genetic structure of S. rubrovittatus reflected post-glacial colonization. Early outbreaks of S. rubrovittatus in the 1980s occurred independently of genetically isolated populations. The genetic structure of the populations did not fit the pattern of an outbreak expansion, and therefore the data did not support the hypothesis that extensive outbreaks were caused by the dispersal of specific pestiferous populations. Rather, the historical genetic structure prior to the outbreaks was maintained throughout the increase in abundance of the mirid bug. Our study indicated that changes in the agro-environment induced multiple outbreaks of native pest populations. This implies that, given suitable environmental conditions, local populations may have the potential to outbreak even without invasion of populations from other environmentally degraded areas.

Syndromic surveillance for local outbreaks of lower-respiratory infections: would it work?

Directory of Open Access Journals (Sweden)

Cees C van den Wijngaard

2010-04-01

Full Text Available Although syndromic surveillance is increasingly used to detect unusual illness, there is a debate whether it is useful for detecting local outbreaks. We evaluated whether syndromic surveillance detects local outbreaks of lower-respiratory infections (LRIs without swamping true signals by false alarms.Using retrospective hospitalization data, we simulated prospective surveillance for LRI-elevations. Between 1999-2006, a total of 290762 LRIs were included by date of hospitalization and patients place of residence (>80% coverage, 16 million population. Two large outbreaks of Legionnaires disease in the Netherlands were used as positive controls to test whether these outbreaks could have been detected as local LRI elevations. We used a space-time permutation scan statistic to detect LRI clusters. We evaluated how many LRI-clusters were detected in 1999-2006 and assessed likely causes for the cluster-signals by looking for significantly higher proportions of specific hospital discharge diagnoses (e.g. Legionnaires disease and overlap with regional influenza elevations. We also evaluated whether the number of space-time signals can be reduced by restricting the scan statistic in space or time. In 1999-2006 the scan-statistic detected 35 local LRI clusters, representing on average 5 clusters per year. The known Legionnaires' disease outbreaks in 1999 and 2006 were detected as LRI-clusters, since cluster-signals were generated with an increased proportion of Legionnaires disease patients (p:<0.0001. 21 other clusters coincided with local influenza and/or respiratory syncytial virus activity, and 1 cluster appeared to be a data artifact. For 11 clusters no likely cause was defined, some possibly representing as yet undetected LRI-outbreaks. With restrictions on time and spatial windows the scan statistic still detected the Legionnaires' disease outbreaks, without loss of timeliness and with less signals generated in time (up to 42% decline.To our

A cholera outbreak in Alborz Province, Iran: a matched case-control study.

Science.gov (United States)

Moradi, Ghobad; Rasouli, Mohammad Aziz; Mohammadi, Parvin; Elahi, Elham; Barati, Hojatollah

2016-01-01

A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks. An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method. In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72). Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

A cholera outbreak in Alborz Province, Iran: a matched case-control study

Directory of Open Access Journals (Sweden)

Ghobad Moradi

2016-05-01

Full Text Available OBJECTIVES: A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks. METHODS: An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs using the logistic regression method. RESULTS: In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41, consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89, and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72. CONCLUSIONS: Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

Control of carbapenemase-producing Enterobacteriaceae outbreaks in acute settings: an evidence review.

Science.gov (United States)

French, C E; Coope, C; Conway, L; Higgins, J P T; McCulloch, J; Okoli, G; Patel, B C; Oliver, I

2017-01-01

In recent years, infections with carbapenemase-producing Enterobacteriaceae (CPE) have been increasing globally and present a major public health challenge. To review the international literature: (i) to describe CPE outbreaks in acute hospital settings globally; and (ii) to identify the control measures used during these outbreaks and report on their effectiveness. A systematic search of MEDLINE and EMBASE databases, abstract lists for key conferences and reference lists of key reviews was undertaken, and information on unpublished outbreaks was sought for 2000-2015. Where relevant, risk of bias was assessed using the Newcastle-Ottawa scale. A narrative synthesis of the evidence was conducted. Ninety-eight outbreaks were eligible. These occurred worldwide, with 53 reports from Europe. The number of cases (CPE infection or colonization) involved in outbreaks varied widely, from two to 803. In the vast majority of outbreaks, multi-component infection control measures were used, commonly including: patient screening; contact precautions (e.g. gowns, gloves); handwashing interventions; staff education or monitoring; enhanced environmental cleaning/decontamination; cohorting of patients and/or staff; and patient isolation. Seven studies were identified as providing the best-available evidence on the effectiveness of control measures. These demonstrated that CPE outbreaks can be controlled successfully using a range of appropriate, commonly used, infection control measures. However, risk of bias was considered relatively high for these studies. The findings indicate that CPE outbreaks can be controlled using combinations of existing measures. However, the quality of the evidence base is weak and further high-quality research is needed, particularly on the effectiveness of individual infection control measures. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

[Foodborne disease outbreaks around the urban Chilean areas from 2005 to 2010].

Science.gov (United States)

Alerte, Viller; Cortés A, Sandra; Díaz T, Janepsy; Vollaire Z, Jeannette; Espinoza M, M Eugenia; Solari G, Verónica; Cerda L, Jaime; Torres H, Marisa

2012-02-01

Foodborne disease outbreaks are one of the main health problems all over the world, which have an extensive impact on human health. [corrected] To analyze the foodborne disease outbreaks occurred in Chilean urban area from 2005 to 2010. We made a descriptive epidemiologic study. First, criteria were defined and classified according to previous epidemiologic investigations, clinical and environment samples, then. Variables of space, time, place and person were also analyzed. Among 2,806 reported outbreaks, 2434 (86.7%) fulfilled the inclusion criteria. Incidence rate of the period (2005-2010) were 32 cases per 100 inhabitants. A total of 12,196 people were affected, with an average of 5 patients per outbreak. The households (36.2%), restaurants (16.3%), supermarkets (6.3%) free fair (4.4%) have been the most important outbreak areas. The foods involved were seafood (15.4%), fish (15.1%), and fast food (13.5%). The etiologic agents were Salmonella spp, Shigella spp, Vibrio parahaemolyticus. Outbreaks foodborne diseases are frequents in the Chilean urban area, which make vulnerable a lot of people. The largest numbers happened in the households and were due to bad handling and/or inappropriate storage of the foods.

[First ciguatera outbreak in Germany in 2012].

Science.gov (United States)

Friedemann, Miriam

2016-12-01

In November 2012, 23 cases of ciguatera with typical combinations of gastrointestinal and neurological symptoms occurred in Germany after consumption of imported tropical fish (Lutjanus spp.). A questionnaire was used to gather information on the disease course and fish consumption. All patients suffered from pathognomonic cold allodynia. Aside from two severe courses of illness, all other cases showed symptoms of moderate intensity. During a three-year follow-up, seven patients reported prolonged paresthesia for more than one year. Two of them reported further neuropathies over almost three years. This is the first time that long-term persistence of symptoms has been documented in detail. Outbreak cases were allocated to eight clusters in seven German cities. A further cluster was prevented by the successful recall of ciguatoxic fish. Three clusters were confirmed by the detection of ciguatoxin in samples of suspicious and recalled fish. An extrapolation on the basis of ciguatoxic samples revealed twenty prevented cases of ciguatera. Further officially unknown cases should be assumed. During the outbreak investigations, inadvertently falsely labelled fish species and fishing capture areas on import and retail level documents were observed. The ascertainment of cases and the outbreak investigations proved to be difficult due to inconsistent case reports to poisons centers, local health and veterinary authorities. In Germany, many physicians are unaware of the disease pattern of ciguatera and the risks caused by tropical fish. The occurrence of further outbreaks during the following years emphasizes the increasing significance of ciguatera in Germany.

Economic costs of outbreaks of acute viral gastroenteritis due to norovirus in Catalonia (Spain), 2010-2011.

Science.gov (United States)

Navas, Encarna; Torner, Nuria; Broner, Sonia; Godoy, Pere; Martínez, Ana; Bartolomé, Rosa; Domínguez, Angela

2015-10-01

To determine the direct and indirect costs of outbreaks of acute viral gastroenteritis (AVG) due to norovirus in closed institutions (hospitals, social health centers or nursing homes) and the community in Catalonia in 2010-11. Information on outbreaks were gathered from the reports made by epidemiological surveillance units. Direct costs (medical visits, hospital stays, drug treatment, sample processing, transport, diagnostic tests, monitoring and control of the outbreaks investigated) and indirect costs (lost productivity due to work absenteeism, caregivers time and working hours lost due to medical visits) were calculated. Twenty-seven outbreaks affecting 816 people in closed institutions and 74 outbreaks affecting 1,940 people in the community were detected. The direct and indirect costs of outbreaks were € 131,997.36 (€ 4,888.79 per outbreak) in closed institutions and € 260,557.16 (€ 3,521.04 per outbreak) in community outbreaks. The cost per case was € 161.76 in outbreaks in closed institutions and € 134.31 in community outbreaks. The main costs were surveillance unit monitoring (€ 116,652.93), laboratory diagnoses (€ 119,950.95), transport of samples (€ 69,970.90), medical visits (€ 25,250.50) and hospitalization (€ 13,400.00). The cost of outbreaks of acute viral gastroenteritis due to norovirus obtained in this study was influenced by the number of people affected and the severity of the outbreak, which determined hospitalizations and work absenteeism. Urgent reporting of outbreaks would allow the implementation of control measures that could reduce the numbers affected and the duration of the illness and thus the costs derived from them.

Characteristics of a large mumps outbreak: Clinical severity, complications and association with vaccination status of mumps outbreak cases.

Science.gov (United States)

Zamir, C Stein; Schroeder, H; Shoob, H; Abramson, N; Zentner, G

2015-01-01

In recent years, large mumps outbreaks, involving mainly adolescents and young adults, have re-emerged in several countries. We investigated a large mumps outbreak, evaluated the association between mumps clinical severity (complications, hospitalization) and vaccination status (number of previous measles, mumps and rubella - MMR vaccine doses), and assessed vaccine effectiveness. The first mumps cases emerged in an ultra-orthodox boys' school in Jerusalem and were epidemiologically linked to the mumps outbreak in New York. Overall, 3130 mumps cases were notified in the Jerusalem district during September 2009-August 2011 (median age 13y, 64% males). Most cases were reported from community clinics. Patients with systemic symptoms and/or complications (419, 13.4%) were either hospitalized (n = 79) or treated in an emergency medical center (n = 340). The main complications included orchitis (3.8% males> age 12y) and meningoencephalitis (0.5%). The mumps virus genotype was G5. The distribution of previous MMR vaccine doses (n = 0,1,2) was: 24.8%, 28.3% and 46.9%, respectively. The number of previous vaccine doses was inversely associated with clinical severity. Adjusted values for MMR vaccine effectiveness against complications were estimated as 52.1% (95% CI -4 -78%) for one vaccine dose and 62.7% (95% CI 25.7-81.3%) for 2 doses. The outbreak was characterized by predominance of male students; the majority of whom had been previously vaccinated. The reported complication rate was relatively low. Vaccination status was associated with age and disease severity. The combination of limited mumps vaccine effectiveness and the specific school setting (dense learning and living conditions) probably contributed to the disease spread.

An outbreak of cholera from food served on an international aircraft.

OpenAIRE

Eberhart-Phillips, J.; Besser, R. E.; Tormey, M. P.; Koo, D.; Feikin, D.; Araneta, M. R.; Wells, J.; Kilman, L.; Rutherford, G. W.; Griffin, P. M.; Baron, R.; Mascola, L.

1996-01-01

In February 1992, an outbreak of cholera occurred among persons who had flown on a commercial airline flight from South America to Los Angeles. This study was conducted to determine the magnitude and the cause of the outbreak. Passengers were interviewed and laboratory specimens were collected to determine the magnitude of the outbreak. A case-control study was performed to determine the vehicle of infection. Seventy-five of the 336 passengers in the United States had cholera; 10 were hospita...

Can tail damage outbreaks in the pig be predicted by behavioural change?

DEFF Research Database (Denmark)

Larsen, Mona Lilian Vestbjerg; Andersen, Heidi Mai-Lis; Pedersen, Lene Juul

2016-01-01

preventive methods. One strategy is the surveillance of the pigs' behaviour for known preceding indicators of tail damage, which makes it possible to predict a tail damage outbreak and prevent it in proper time. This review discusses the existing literature on behavioural changes observed prior to a tail...... damage outbreak. Behaviours found to change prior to an outbreak include increased activity level, increased performance of enrichment object manipulation, and a changed proportion of tail posture with more tails between the legs. Monitoring these types of behaviours is also discussed for the purpose......, starting with the description of the temporal development of the predictive behaviour in relation to tail damage outbreaks...

Analysis and Modeling of Influenza Outbreaks as Driven by Weather

Science.gov (United States)

Thrastarson, H. T.; Teixeira, J.; Serman, E. A.; Parekh, A.; Yeo, E.

2017-12-01

Seasonal influenza outbreaks are a major source of illness, mortality and economic burden worldwide. Attributing what drives the seasonality of the outbreaks is still an unsettled problem. But in temperate regions absolute humidity conditions are a strong candidate (Shaman et al., 2010) and some studies have associated temperature conditions with influenza outbreaks. We use humidity and temperature data from NASA's AIRS (Atmospheric Infra-Red Sounder) instrument as well as data for influenza incidence in the US and South Africa to explore the connection between weather and influenza seasonality at different spatial scales. We also incorporate influenza surveillance data, satellite data and humidity forecasts into a numerical epidemiological prediction system. Our results give support for the role of local weather conditions as drivers of the seasonality of influenza in temperate regions. This can have implications for public health efforts where forecasting of the timing and intensity of influenza outbreaks has a great potential role (e.g., aiding management and organization of vaccines, drugs and other resources).

Linking healthcare associated norovirus outbreaks: a molecular epidemiologic method for investigating transmission

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Andrews Nick

2006-07-01

Full Text Available Abstract Background Noroviruses are highly infectious pathogens that cause gastroenteritis in the community and in semi-closed institutions such as hospitals. During outbreaks, multiple units within a hospital are often affected, and a major question for control programs is: are the affected units part of the same outbreak or are they unrelated transmission events? In practice, investigators often assume a transmission link based on epidemiological observations, rather than a systematic approach to tracing transmission. Here, we present a combined molecular and statistical method for assessing: 1 whether observed clusters provide evidence of local transmission and 2 the probability that anecdotally|linked outbreaks truly shared a transmission event. Methods 76 healthcare associated outbreaks were observed in an active and prospective surveillance scheme of 15 hospitals in the county of Avon, England from April 2002 to March 2003. Viral RNA from 64 out of 76 specimens from distinct outbreaks was amplified by reverse transcription-PCR and was sequenced in the polymerase (ORF 1 and capsid (ORF 2 regions. The genetic diversity, at the nucleotide level, was analysed in relation to the epidemiological patterns. Results Two out of four genetic and epidemiological clusters of outbreaks were unlikely to have occurred by chance alone, thus suggesting local transmission. There was anecdotal epidemiological evidence of a transmission link among 5 outbreaks pairs. By combining this epidemiological observation with viral sequence data, the evidence of a link remained convincing in 3 of these pairs. These results are sensitive to prior beliefs of the strength of epidemiological evidence especially when the outbreak strains are common in the background population. Conclusion The evidence suggests that transmission between hospitals units does occur. Using the proposed criteria, certain hypothesized transmission links between outbreaks were supported while

First chikungunya outbreak in Pakistan: a trail of viral attacks

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T.H. Mallhi

2017-09-01

Full Text Available Despite explicit warning from the National Institute of Health, Pakistan experienced its first chikungunya outbreak in the metropolis of Karachi. We underscore the attention of health authorities and healthcare professionals towards contributing factors associated with this outbreak and the measures required to combat this viral disease.

Lessons from worldwide measles out-breaks in 2011-2012 and ...

African Journals Online (AJOL)

Measles is a leading cause of under-five mortality among vaccine preventable diseases in today's developing world. In fact, Tanzania has been experiencing measles out-breaks almost every year. Since last year, the world has experienced several out-breaks in several areas including many developed countries with high ...

Case Series: Outbreak of Conversion Disorder among Amish Adolescent Girls.

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Cassady, Joslyn D.; Kirschke, David L.; Jones, Timothy F.; Craig, Allen S.; Bermudez, Ovidio B.; Schaffner, William

2005-01-01

Objective: Outbreak investigations are challenging in a cross-cultural context, and outbreaks of psychiatric disease are rare in any community. We investigated a cluster of unexplained debilitating illness among Amish girls. Method: We reviewed the medical records of cases, consulted with health care providers, performed active case finding,…

Rapid response to Ebola outbreaks in remote areas - Liberia, July-November 2014.

Science.gov (United States)

Kateh, Francis; Nagbe, Thomas; Kieta, Abraham; Barskey, Albert; Gasasira, Alex Ntale; Driscoll, Anne; Tucker, Anthony; Christie, Athalia; Karmo, Ben; Scott, Colleen; Bowah, Collin; Barradas, Danielle; Blackley, David; Dweh, Emmanuel; Warren, Felicia; Mahoney, Frank; Kassay, Gabriel; Calvert, Geoffrey M; Castro, Georgina; Logan, Gorbee; Appiah, Grace; Kirking, Hannah; Koon, Hawa; Papowitz, Heather; Walke, Henry; Cole, Isaac B; Montgomery, Joel; Neatherlin, John; Tappero, Jordan W; Hagan, Jose E; Forrester, Joseph; Woodring, Joseph; Mott, Joshua; Attfield, Kathleen; DeCock, Kevin; Lindblade, Kim A; Powell, Krista; Yeoman, Kristin; Adams, Laura; Broyles, Laura N; Slutsker, Laurence; Larway, Lawrence; Belcher, Lisa; Cooper, Lorraine; Santos, Marjorie; Westercamp, Matthew; Weinberg, Meghan Pearce; Massoudi, Mehran; Dea, Monica; Patel, Monita; Hennessey, Morgan; Fomba, Moses; Lubogo, Mutaawe; Maxwell, Nikki; Moonan, Patrick; Arzoaquoi, Sampson; Gee, Samuel; Zayzay, Samuel; Pillai, Satish; Williams, Seymour; Zarecki, Shauna Mettee; Yett, Sheldon; James, Stephen; Grube, Steven; Gupta, Sundeep; Nelson, Thelma; Malibiche, Theophil; Frank, Wilmont; Smith, Wilmot; Nyenswah, Tolbert

2015-02-27

West Africa is experiencing its first epidemic of Ebola virus disease (Ebola). As of February 9, Liberia has reported 8,864 Ebola cases, of which 3,147 were laboratory-confirmed. Beginning in August 2014, the Liberia Ministry of Health and Social Welfare (MOHSW), supported by CDC, the World Health Organization (WHO), and others, began systematically investigating and responding to Ebola outbreaks in remote areas. Because many of these areas lacked mobile telephone service, easy road access, and basic infrastructure, flexible and targeted interventions often were required. Development of a national strategy for the Rapid Isolation and Treatment of Ebola (RITE) began in early October. The strategy focuses on enhancing capacity of county health teams (CHT) to investigate outbreaks in remote areas and lead tailored responses through effective and efficient coordination of technical and operational assistance from the MOHSW central level and international partners. To measure improvements in response indicators and outcomes over time, data from investigations of 12 of 15 outbreaks in remote areas with illness onset dates of index cases during July 16-November 20, 2014, were analyzed. The times to initial outbreak alerts and durations of the outbreaks declined over that period while the proportions of patients who were isolated and treated increased. At the same time, the case-fatality rate in each outbreak declined. Implementation of strategies, such as RITE, to rapidly respond to rural outbreaks of Ebola through coordinated and tailored responses can successfully reduce transmission and improve outcomes.

Outbreak of acute hemorrhagic conjunctivitis in Yunnan, People's Republic of China, 2007

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Xu Wenbo

2010-06-01

Full Text Available Abstract An outbreak of acute hemorrhagic conjunctivitis (AHC occurred in Yunnan Province, China between August and September in 2007. A total of 3,597 cases were officially reported and the incidence rate reached 1390.94/100,000. Descriptive epidemiological analysis of the outbreak was conducted using the data from National Disease Supervision Information Management System (NDSIMS. To determine the causative agent for this outbreak and to analyze their genetic features, 30 conjunctival swabs and 19 paired serum specimens of acute and convalescent phase were collected from 30 patients with AHC, and viral isolation, molecular typing, antibody assay and phylogenetic analysis were performed. 11 virus strains were isolated from 30 conjunctival swabs. Amplification and sequencing of the VP4 region of these strains identified that coxsackievirus A24 variant (CA24v could be the causative agent of the AHC outbreak and this was further confirmed by subsequent virus neutralizing antibody test on 19 paired serum specimens. Phylogenetic analysis based on the 3C regions showed that the Yunnan CA24v strains belonged to Group 3 and clustered with the strains isolated from worldwide AHC outbreaks after 2002. Phylogenetic analysis based on the partial VP1 revealed that the Yunnan strains differed from the strains isolated from AHC outbreak in Guangdong of China in 2007 with 2.8 - 3.0% nucleotide divergence, suggesting that two different lineages of CA24v caused the independent AHC outbreaks in Yunnan and Guangdong, respectively.

Legionnaires’ Disease: Clinicoradiological Comparison of Sporadic Versus Outbreak Cases

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Hafiz Rizwan Talib Hashmi

2017-06-01

Full Text Available Background: In 2015, New York City experienced the worst outbreak of Legionnaires’ disease in the history of the city. We compare patients seen during the 2015 outbreak with sporadic cases of Legionella during the past 5 years. Methods: We conducted a retrospective chart review of 90 patients with Legionnaires’ disease, including sporadic cases of Legionella infection admitted from 2010 to 2015 (n = 55 and cases admitted during the 2015 outbreak (n = 35. Results: We saw no significant differences between the 2 groups regarding demographics, smoking habits, alcohol intake, underlying medical disease, or residence type. Univariate and multivariate analyses showed that patients with sporadic case of Legionella had a longer stay in the hospital and intensive care unit as well as an increased stay in mechanical ventilation. Short-term mortality, discharge disposition, and most clinical parameters did not differ significantly between the 2 groups. Conclusions: We found no specific clinicoradiological characteristics that could differentiate sporadic from epidemic cases of Legionella . Early recognition and high suspicion for Legionnaires’ disease are critical to provide appropriate treatment. Cluster of cases should increase suspicion for an outbreak.

Primary and secondary cases in Escherichia coli O157 outbreaks: a statistical analysis.

LENUS (Irish Health Repository)

Snedeker, Kate G

2009-01-01

BACKGROUND: Within outbreaks of Escherichia coli O157 (E. coli O157), at least 10-15% of cases are thought to have been acquired by secondary transmission. However, there has been little systematic quantification or characterisation of secondary outbreak cases worldwide. The aim of this study was to characterise secondary outbreak cases, estimate the overall proportion of outbreak cases that were the result of secondary transmission and to analyse the relationships between primary and secondary outbreak cases by mode of transmission, country and median age. METHODS: Published data was obtained from 90 confirmed Escherichia coli O157 outbreaks in Great Britain, Ireland, Scandinavia, Canada, the United States and Japan, and the outbreaks were described in terms of modes of primary and secondary transmission, country, case numbers and median case age. Outbreaks were tested for statistically significant differences in the number of ill, confirmed, primary and secondary cases (analysis of variance and Kruskal-Wallis) and in the rate of secondary cases between these variables (Generalised Linear Models). RESULTS: The outbreaks had a median of 13.5 confirmed cases, and mean proportion of 0.195 secondary cases. There were statistically significant differences in the numbers of ill, confirmed, primary and secondary cases between modes of primary transmission (p < 0.021), and in primary and secondary cases between median age categories (p < 0.039) and modes of secondary transmission (p < 0.001).Secondary case rates differed statistically significantly between modes of secondary and primary transmission and median age categories (all p < 0.001), but not between countries (p = 0.23). Statistically significantly higher rates of secondary transmission were found in outbreaks with a median age <6 years and those with secondary transmission via person to person spread in nurseries. No statistically significant interactions were found between country, mode of transmission and age

Impact of delay on disease outbreak in a spatial epidemic model

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Zhao, Xia-Xia; Wang, Jian-Zhong

2015-04-01

One of the central issues in studying epidemic spreading is the mechanism on disease outbreak. In this paper, we investigate the effects of time delay on disease outbreak in spatial epidemics based on a reaction-diffusion model. By mathematical analysis and numerical simulations, we show that when time delay is more than a critical value, the disease outbreaks. The obtained results show that the time delay is an important factor in the spread of the disease, which may provide new insights on disease control.

The Influenza Virus and the 2009 H1N1 Outbreak

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2016-04-08

MDW/SGVU SUBJECT: Professional Presentation Approval 8 APR 2016 1. Your paper, entitled The Influenza Virus and the 2009 HlNl Outbreak presented at...L TO BE PUBLISHED OR PRESENTED The Influenza Virus and the 2009 H1N1 Outbreak 2. FUNDING RECEIVED FOR THIS STUDY? DYES [g] NO FUNDING SOURCE: I I...336:!. ~~ 2 C-; MARKE. COON. :vtajor. USAF Acting Chic!’. Civil I.aw The Influenza Virus and the 2009 H 1 N 1 Outbreak Thomas. F. Gibbons, Ph.D

Devising a method towards development of early warning tool for detection of malaria outbreak.

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Verma, Preeti; Sarkar, Soma; Singh, Poonam; Dhiman, Ramesh C

2017-11-01

Uncertainty often arises in differentiating seasonal variation from outbreaks of malaria. The present study was aimed to generalize the theoretical structure of sine curve for detecting an outbreak so that a tool for early warning of malaria may be developed. A 'case/mean-ratio scale' system was devised for labelling the outbreak in respect of two diverse districts of Assam and Rajasthan. A curve-based method of analysis was developed for determining outbreak and using the properties of sine curve. It could be used as an early warning tool for Plasmodium falciparum malaria outbreaks. In the present method of analysis, the critical C max (peak value of sine curve) value of seasonally adjusted curve for P. falciparum malaria outbreak was 2.3 for Karbi Anglong and 2.2 for Jaisalmer districts. On case/mean-ratio scale, the C max value of malaria curve between C max and 3.5, the outbreak could be labelled as minor while >3.5 may be labelled as major. In epidemic years, with mean of case/mean ratio of ≥1.00 and root mean square (RMS) ≥1.504 of case/mean ratio, outbreaks can be predicted 1-2 months in advance. The present study showed that in P. falciparum cases in Karbi Anglong (Assam) and Jaisalmer (Rajasthan) districts, the rise in C max value of curve was always followed by rise in average/RMS or both and hence could be used as an early warning tool. The present method provides better detection of outbreaks than the conventional method of mean plus two standard deviation (mean+2 SD). The identified tools are simple and may be adopted for preparedness of malaria outbreaks.

Using routinely reported tuberculosis genotyping and surveillance data to predict tuberculosis outbreaks.

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Sandy P Althomsons

Full Text Available We combined routinely reported tuberculosis (TB patient characteristics with genotyping data and measures of geospatial concentration to predict which small clusters (i.e., consisting of only 3 TB patients in the United States were most likely to become outbreaks of at least 6 TB cases. Of 146 clusters analyzed, 16 (11.0% grew into outbreaks. Clusters most likely to become outbreaks were those in which at least 1 of the first 3 patients reported homelessness or excess alcohol or illicit drug use or was incarcerated at the time of TB diagnosis and in which the cluster grew rapidly (i.e., the third case was diagnosed within 5.3 months of the first case. Of 17 clusters with these characteristics and therefore considered high risk, 9 (53% became outbreaks. This retrospective cohort analysis of clusters in the United States suggests that routinely reported data may identify small clusters that are likely to become outbreaks and which are therefore candidates for intensified contact investigations.

International employees' concerns during serious disease outbreaks and the potential impact on business continuity: Lessons identified from the 2014-15 West African Ebola outbreak.

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Cole, Jennifer; Watkins, Chris

This paper presents the findings of research carried out into the information-seeking behaviour, and information requirements of a small sample of international workers stationed in West Africa during the Zaire Ebola virus outbreak of 2014-15. The research study under which these results were obtained was part of exploratory research for a PhD focused on the use, and potential uses, of social media platforms during serious disease outbreaks that might be used to inform policy planning for public health and emergency response interventions. Thus, the findings from this study may provide valuable insights to business continuity managers and emergency planners in making future decisions about information exchange and crisis decision-making during future serious disease outbreaks.

Did the Ebola Outbreak Disrupt Immunisation Services? A Case Study from Liberia

OpenAIRE

Wesseh, C; Najjemba, R; Edwards, J; Owiti, P; Tweya, H; Bhat, P

2017-01-01

Setting: All health facilities providing routine immunisation services in Liberia. Objective: To compare the number of routine facility-based and outreach immunisations and measles cases before, during and after the Ebola outbreak. Design: A descriptive cross-sectional study. Results: Immunisation coverage for fully immunised children before the Ebola outbreak was 73%. Immunisation coverage for all antigens declined by half compared to baseline during the outbreak. These findings were similar...

Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control.

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Matua, Gerald Amandu; Van der Wal, Dirk Mostert; Locsin, Rozzano C

2015-01-01

Ebola hemorrhagic fever, caused by the highly virulent RNA virus of the filoviridae family, has become one of the world's most feared pathogens. The virus induces acute fever and death, often associated with hemorrhagic symptoms in up to 90% of infected patients. The known sub-types of the virus are Zaire, Sudan, Taï Forest, Bundibugyo and Reston Ebola viruses. In the past, outbreaks were limited to the East and Central African tropical belt with the exception of Ebola Reston outbreaks that occurred in animal facilities in the Philippines, USA and Italy. The on-going outbreak in West Africa that is causing numerous deaths and severe socio-economic challenges has resulted in widespread anxiety globally. This panic may be attributed to the intense media interest, the rapid spread of the virus to other countries like United States and Spain, and moreover, to the absence of an approved treatment or vaccine. Informed by this widespread fear and anxiety, we analyzed the commonly used strategies to manage and control Ebola outbreaks and proposed new approaches that could improve epidemic management and control during future outbreaks. We based our recommendations on epidemic management practices employed during recent outbreaks in East, Central and West Africa, and synthesis of peer-reviewed publications as well as published "field" information from individuals and organizations recently involved in the management of Ebola epidemics. The current epidemic management approaches are largely "reactive", with containment efforts aimed at halting spread of existing outbreaks. We recommend that for better outcomes, in addition to "reactive" interventions, "pre-emptive" strategies also need to be instituted. We conclude that emphasizing both "reactive" and "pre-emptive" strategies is more likely to lead to better epidemic preparedness and response at individual, community, institutional, and government levels, resulting in timely containment of future Ebola outbreaks. Copyright

Ebola viral hemorrhagic disease outbreak in West Africa- lessons from Uganda.

Science.gov (United States)

Mbonye, Anthony K; Wamala, Joseph F; Nanyunja, Miriam; Opio, Alex; Makumbi, Issa; Aceng, Jane Ruth

2014-09-01

There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda's experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa. The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. Lessons learnt: The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility. Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.

Response to a Large Polio Outbreak in a Setting of Conflict - Middle East, 2013-2015.

Science.gov (United States)

Mbaeyi, Chukwuma; Ryan, Michael J; Smith, Philip; Mahamud, Abdirahman; Farag, Noha; Haithami, Salah; Sharaf, Magdi; Jorba, Jaume C; Ehrhardt, Derek

2017-03-03

As the world advances toward the eradication of polio, outbreaks of wild poliovirus (WPV) in polio-free regions pose a substantial risk to the timeline for global eradication. Countries and regions experiencing active conflict, chronic insecurity, and large-scale displacement of persons are particularly vulnerable to outbreaks because of the disruption of health care and immunization services (1). A polio outbreak occurred in the Middle East, beginning in Syria in 2013 with subsequent spread to Iraq (2). The outbreak occurred 2 years after the onset of the Syrian civil war, resulted in 38 cases, and was the first time WPV was detected in Syria in approximately a decade (3,4). The national governments of eight countries designated the outbreak a public health emergency and collaborated with partners in the Global Polio Eradication Initiative (GPEI) to develop a multiphase outbreak response plan focused on improving the quality of acute flaccid paralysis (AFP) surveillance* and administering polio vaccines to >27 million children during multiple rounds of supplementary immunization activities (SIAs). † Successful implementation of the response plan led to containment and interruption of the outbreak within 6 months of its identification. The concerted approach adopted in response to this outbreak could serve as a model for responding to polio outbreaks in settings of conflict and political instability.

Management of rodent viral disease outbreaks: one institutions (r)evolution.

Science.gov (United States)

Smith, Abigail L

2010-01-01

At first blush, an outbreak of mouse hepatitis virus or epizootic diarrhea of infant mice virus in a research colony of laboratory mice may not seem like a disaster. However, irrespective of magnitude, such an outbreak at an academic institution is disruptive for researchers at all levels. It can be a disaster for the graduate student who may have just a few experiments to finish before writing the thesis or for the postdoctoral fellow who is in the lab for only 1 or 2 years. Infectious disease outbreaks also limit the ability of principal investigators to share their animals with collaborators at their home institution as well as with those at extramural sites, thereby thwarting the expectation that research materials supported by federal funds will be made readily available to colleagues. This article traces the evolution of a change in culture at a large, well-funded academic institution with over 1,800 active IACUC protocols, more than 1,000 of which include mice. During a period of less than 5 years, the institution evolved from virtual paralysis in the face of such outbreaks to the implementation of policies and practices that enable effective outbreak management and the timely resumption of research functionality. This evolution required not only support from the highest levels of leadership in the university and its school of medicine but also a huge outlay of financial resources.

Severe canine distemper outbreak in unvaccinated dogs in Mozambique

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Julieta Zacarias

2016-07-01

Full Text Available Although significant animal suffering caused by preventable diseases is frequently seen in developing countries, reports of this are scarce. This report describes avoidable animal suffering owing to a suspected canine distemper (CD outbreak in unvaccinated dogs owned by low-income families in Mozambique that killed approximately 200 animals. Affected dogs exhibited clinical signs, and gross and microscopic lesions compatible with CD. Immunohistochemical staining confirmed the presence of canine distemper virus (CDV in the kidney of one dog from the cohort. This brief communication again illustrates that large outbreaks of CDV in unvaccinated dogs occur and that large-scale avoidable suffering and threats to the health of dogs and wild canines continue. Mass vaccination supported by government and non-government organisations is recommended. Keywords: Canine distemper; dogs; outbreak; animal welfare; Mozambique

Viewpoint: methanol poisoning outbreak in Libya: a need for policy reforms.

Science.gov (United States)

Taleb, Ziyad Ben; Bahelah, Raed

2014-11-01

We address the controversies surrounding a 2013 outbreak of methanol poisoning in Tripoli, Libya. We critically examine and systematically analyze the outbreak to highlight the lessons learned from this disaster and how to act properly to prevent similar outbreaks in future. Many health problems have been directly attributed to drinking alcohol; the type and quality of alcohol determines the detrimental effects. An unregulated and flourishing black market in alcohol is among the factors behind the Libyan tragedy, where approximately 90 deaths and about 1000 hospital admissions were reported. We reviewed gaps in local and regional alcohol policy, and highlighted the issue of illegally produced and home-made alcohol. Collaboration between countries in the region plus critical health and policy reforms in Libya, with emphasis on public health preparedness, can dramatically decrease morbidity and mortality associated with such outbreaks.

Societal impact of dengue outbreaks: Stakeholder perceptions and related implications. A qualitative study in Brazil, 2015.

Science.gov (United States)

Ladner, Joël; Rodrigues, Mariana; Davis, Ben; Besson, Marie-Hélène; Audureau, Etienne; Saba, Joseph

2017-03-01

The growing burden of dengue in many countries worldwide and the difficulty of preventing outbreaks have increased the urgency to identify alternative public health management strategies and effective approaches to control and prevent dengue outbreaks. The objectives of this study were to understand the impact of dengue outbreak on different stakeholders in Brazil, to explore their perceptions of approaches used by governmental authorities to control and prevent dengue outbreaks and to define the challenges and implications of preventing future outbreaks. In 2015, a qualitative study was conducted in two urban states in Brazil: São Paulo, which was experiencing an outbreak in 2015, and Rio de Janeiro, which experienced outbreaks in 2011 and 2012. Face-to-face interviews using a semi-structured questionnaire were conducted with nine different categories of stakeholders: health workers (physicians, nurses), hospital administrators, municipal government representatives, community members and leaders, school administrators, business leaders and vector control managers. Interviews were focused on the following areas: impact of the dengue outbreak, perceptions of control measures implemented by governmental authorities during outbreaks and challenges in preventing future dengue outbreaks. A total of 40 stakeholders were included in the study. Health workers and community members reported longer waiting times at hospitals due to the increased number of patients receiving care for dengue-related symptoms. Health workers and hospital administrators reported that there were no major interruptions in access to care. Overall financial impact of dengue outbreaks on households was greatest for low-income families. Despite prevention and control campaigns implemented between outbreak periods, various stakeholders reported that dengue prevention and control efforts performed by municipal authorities remained insufficient, suggesting that efforts should be reinforced and better

Large multistate outbreak of norovirus gastroenteritis associated with frozen strawberries, Germany, 2012.

Science.gov (United States)

Bernard, H; Faber, M; Wilking, H; Haller, S; Höhle, M; Schielke, A; Ducomble, T; Siffczyk, C; Merbecks, S S; Fricke, G; Hamouda, O; Stark, K; Werber, D

2014-02-27

From 20 September through 5 October 2012, the largest recorded food-borne outbreak in Germany occurred. Norovirus was identified as the causative agent. We conducted four analytical epidemiological studies, two case–control studies and two surveys (in total 150 cases) in secondary schools in three different federal states. Overall, 390 institutions in five federal states reported nearly 11,000 cases of gastroenteritis. They were predominantly schools and childcare facilities and were supplied almost exclusively by one large catering company. The analytical epidemiological studies consistently identified dishes containing strawberries as the most likely vehicle, with estimated odds ratios ranging from 2.6 to 45.4. The dishes had been prepared in different regional kitchens of the catering company and were served in the schools two days before the peaks of the respective outbreaks. All affected institutions had received strawberries of one lot, imported frozen from China. The outbreak vehicle was identified within a week, which led to a timely recall and prevented more than half of the lot from reaching the consumer. This outbreak exemplifies the risk of large outbreaks in the era of global food trade. It underlines the importance of timely surveillance and epidemiological outbreak investigations for food safety.

Can tail damage outbreaks in the pig be predicted by behavioural change?

Science.gov (United States)

Larsen, Mona Lilian Vestbjerg; Andersen, Heidi Mai-Lis; Pedersen, Lene Juul

2016-03-01

Tail biting, resulting in outbreaks of tail damage in pigs, is a multifactorial welfare and economic problem which is usually partly prevented through tail docking. According to European Union legislation, tail docking is not allowed on a routine basis; thus there is a need for alternative preventive methods. One strategy is the surveillance of the pigs' behaviour for known preceding indicators of tail damage, which makes it possible to predict a tail damage outbreak and prevent it in proper time. This review discusses the existing literature on behavioural changes observed prior to a tail damage outbreak. Behaviours found to change prior to an outbreak include increased activity level, increased performance of enrichment object manipulation, and a changed proportion of tail posture with more tails between the legs. Monitoring these types of behaviours is also discussed for the purpose of developing an automatic warning system for tail damage outbreaks, with activity level showing promising results for being monitored automatically. Encouraging results have been found so far for the development of an automatic warning system; however, there is a need for further investigation and development, starting with the description of the temporal development of the predictive behaviour in relation to tail damage outbreaks. Copyright © 2016 Elsevier Ltd. All rights reserved.

High case fatality cholera outbreak in Western Kenya, August 2010

African Journals Online (AJOL)

abp

Abstract. Introduction: Cholera is a disease caused by the bacterium Vibrio cholera and has been an important public health problem since its first pandemic in 1817. Kenya has had numerous outbreaks of cholera ever since it was first detected there during 1971. In August 2010 an outbreak of cholera occurred in Kuria ...

Field assessment of a model tuberculosis outbreak response plan for low-incidence areas

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Pascopella Lisa

2007-10-01

Full Text Available Abstract Background For a regional project in four low-incidence states, we designed a customizable tuberculosis outbreak response plan. Prior to dissemination of the plan, a tuberculosis outbreak occurred, presenting an opportunity to perform a field assessment of the plan. The purpose of the assessment was to ensure that the plan included essential elements to help public health professionals recognize and respond to outbreaks. Methods We designed a semi-structured questionnaire and interviewed all key stakeholders involved in the response. We used common themes to assess validity of and identify gaps in the plan. A subset of participants provided structured feedback on the plan. Results We interviewed 11 public health and six community stakeholders. The assessment demonstrated that (1 almost all of the main response activities were reflected in the plan; (2 the plan added value by providing a definition of a tuberculosis outbreak and guidelines for communication and evaluation. These were areas that lacked written protocols during the actual outbreak response; and (3 basic education about tuberculosis and the interpretation and use of genotyping data were important needs. Stakeholders also suggested adding to the plan questions for evaluation and a section for specific steps to take when an outbreak is suspected. Conclusion An interactive field assessment of a programmatic tool revealed the value of a systematic outbreak response plan with a standard definition of a tuberculosis outbreak, guidelines for communication and evaluation, and response steps. The assessment highlighted the importance of education and training for tuberculosis in low-incidence areas.

Comparative Analysis of Dengue and Zika Outbreaks Reveals Differences by Setting and Virus.

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Sebastian Funk

2016-12-01

Full Text Available The pacific islands of Micronesia have experienced several outbreaks of mosquito-borne diseases over the past decade. In outbreaks on small islands, the susceptible population is usually well defined, and there is no co-circulation of pathogens. Because of this, analysing such outbreaks can be useful for understanding the transmission dynamics of the pathogens involved, and particularly so for yet understudied pathogens such as Zika virus. Here, we compared three outbreaks of dengue and Zika virus in two different island settings in Micronesia, the Yap Main Islands and Fais, using a mathematical model of transmission dynamics and making full use of commonalities in disease and setting between the outbreaks. We found that the estimated reproduction numbers for Zika and dengue were similar when considered in the same setting, but that, conversely, reproduction number for the same disease can vary considerably by setting. On the Yap Main Islands, we estimated a reproduction number of 8.0-16 (95% Credible Interval (CI for the dengue outbreak and 4.8-14 (95% CI for the Zika outbreak, whereas for the dengue outbreak on Fais our estimate was 28-102 (95% CI. We further found that the proportion of cases of Zika reported was smaller (95% CI 1.4%-1.9% than that of dengue (95% CI: 47%-61%. We confirmed these results in extensive sensitivity analysis. They suggest that models for dengue transmission can be useful for estimating the predicted dynamics of Zika transmission, but care must be taken when extrapolating findings from one setting to another.

Epidemiology and genotype analysis of sapovirus associated with gastroenteritis outbreaks in Alberta, Canada: 2004-2007.

Science.gov (United States)

Pang, Xiaoli L; Lee, Bonita E; Tyrrell, Gregory J; Preiksaitis, Jutta K

2009-02-15

This study describes the epidemiology and circulating strains of sapovirus associated with gastroenteritis outbreaks in Alberta, Canada, from 2004 to 2007. Sapovirus was an important cause of gastroenteritis outbreaks, accounting for 43 (17.6%) of 244 outbreaks in which all samples tested were negative for norovirus. All 4 human sapovirus genotypes, GI, GII, GIV, and GV, were found in samples during these outbreaks. The greatest amount of sapovirus-associated outbreak activity occurred in 2007, after the emergence of genotype GIV in December 2006. The majority of sapovirus-associated outbreaks in Alberta during this period (27 [62.8%] of 43) occurred in hospitals, community long-term care facilities, and senior lodges. Adults>65 years of age were the age group most commonly affected.

Role of Food Handlers in Norovirus Outbreaks in London and South East England, 2013 to 2015.

Science.gov (United States)

Rumble, C; Addiman, S; Balasegaram, S; Chima, K; Ready, D; Heard, J; Alexander, E

2017-02-01

Outbreaks caused by norovirus infection are common and occur throughout the year. Outbreaks can be related to food outlets either through a contaminated food source or an infected food handler. Both asymptomatic and symptomatic food handlers are potentially implicated in outbreaks, but evidence of transmission is limited. To understand potential food handler transmission in outbreak scenarios, epidemiological and microbiological data on possible and confirmed norovirus outbreaks reported in London and South East England in a 2-year period were reviewed. One hundred eighty-six outbreaks were associated with a food outlet or registered caterer in this period. These occurred throughout the year with peaks in quarter 1 of study years. A case series of 17 outbreaks investigated by the local field epidemiological service were evaluated further, representing more than 606 cases. In five outbreaks, symptomatic food handlers were tested and found positive for norovirus. In four outbreaks, symptomatic food handlers were not tested. Asymptomatic food handlers were tested in three outbreaks but positive for norovirus in one only. Environmental sampling did not identify the causative agent conclusively in any of the outbreaks included in this analysis. Food sampling identified norovirus in one outbreak. Recommendations from this study include for outbreak investigations to encourage testing of symptomatic food handlers and for food and environmental samples to be taken as soon as possible. In addition, sampling of asymptomatic food handlers should be considered when possible. However, in light of the complexity in conclusively identifying a source of infection, general measures to improve hand hygiene are recommended, with specific education among food handlers about the potential for foodborne pathogen transmission during asymptomatic infection, as well as reinforcing the importance of self-exclusion from food handling activities when symptomatic.

High case fatality cholera outbreak in Western Kenya, August 2010 ...

African Journals Online (AJOL)

Introduction: Cholera is a disease caused by the bacterium Vibrio cholera and has been an important public health problem since its first pandemic in 1817. Kenya has had numerous outbreaks of cholera ever since it was first detected there during 1971. In August 2010 an outbreak of cholera occurred in Kuria West District ...

Teachers' Risk Perception and Needs in Addressing Infectious Disease Outbreak

Science.gov (United States)

Wong, Emmy M. Y.; Cheng, May M. H.; Lo, S.K.

2010-01-01

The outbreak of the Influenza A (H1N1) virus has led to numerous precautionary school closures in several countries. No research is available on the school teachers' perceptions as a health protective resource in controlling communicable disease outbreaks. The purposes of this study were to examine the risk perception, the perceived understanding…

[Field epidemiological study on a varicella outbreak among schoolchildren in Shenzhen].

Science.gov (United States)

Zheng, Qing-ming; Zeng, Hua-tang; Wang, Tie-qiang; Liu, Yi; Wang, Guang-li; Mei, Shu-jiang; Zhang, Shun-xiang

2013-09-01

Both epidemiologic characteristics and transmission mode of a varicella outbreak among schoolchildren in Shenzhen city were studied and related control measures were discussed. Case definition was established. Case-finding and face-to-face investigation were conducted, followed by analysis on distributions of time, place and persons of the outbreak. Association between possible modes of transmission and the outbreak was explored. Retrospective cohort study was carried out. The overall attack rate of this outbreak was 4.4% (122 of 2742). The attack rate among primary schoolchildren(8.3%, 118/1419)was higher than that in the middle-school children(0.3%, 4/1323). There were no statistically significant differences on the attack rates between male and female students. A total of 22 classes from the 9 grades were affected by this outbreak and the aggregation of varicella cases was found in classes. The highest attack rates was found in the students of fifth grade(23.7%), followed by from the third grade (13.4%). The main transmission mode appeared to be close personal contact. The outbreak, with four peaks of incidence, lasted 72 days. Data from the investigation suggested that the primary case was introduced into the school during military training involved by the students. Activities related to physical examination for all the schoolchildren seemed to have contributed to the spread of this disease among classes. Delayed isolation of cases appeared to be the major factor causing the spread of disease among classes. Intensive off-school activities or free community bus for children did not seem to be associated with the spreading of the disease. 52.5% (64/122) of the cases had received one-dose of varicella vaccine, with the median of onset after the vaccination as 7 years. The results demonstrated that one single-dose vaccine or long vaccination period were factors related to the insufficient immunity that causing the outbreak of disease. Varicella outbreak has been

An Outbreak of Measles in a University in Korea, 2014.

Science.gov (United States)

Choe, Young June; Park, Young Joon; Kim, Ju Whi; Eom, Hye Eun; Park, Ok; Oh, Myoung Don; Lee, Jong Koo

2017-11-01

Measles has been declared eliminated from the Korea since 2006. In April 2014, a measles outbreak occurred at a University in Seoul. A total of 85 measles cases were identified. In order to estimate vaccine effectiveness of measles vaccine, we reviewed the vaccination records of the university students. The vaccine effectiveness of two doses of measles containing vaccine was 60.0% (95% CI, 38.2-74.1; P < 0.05). Transmission was interrupted after the introduction of outbreak-response immunization. The outbreak shows that pockets of under-immunity among college students may have facilitated the disease transmission despite the high 2-dose vaccination coverage in the community. © 2017 The Korean Academy of Medical Sciences.

Management of a Cryptosporidium hominis Outbreak in a Day- care Center

NARCIS (Netherlands)

Vandenberg, Olivier; Robberecht, Françoise; Dauby, Nicolas; Moens, Catherine; Talabani, Hana; Dupont, Eddy; Menotti, Jean; van Gool, Tom; Levy, Jack

2012-01-01

Background: Cryptosporidium outbreaks in day-care centers (DCCs) occur commonly. However, controlling spread of infection in these settings is difficult, and data about effectiveness of different control strategies are sparse. In this study, a Cryptosporidium outbreak in a large DCC located in

A local outbreak of dengue caused by an imported case in Dongguan China

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Peng Hong-Juan

2012-01-01

Full Text Available Abstract Background Dengue, a mosquito-borne febrile viral disease, is found in tropical and sub-tropical regions around the world. Since the first occurrence of dengue was confirmed in Guangdong, China in 1978, dengue outbreaks have been reported sequentially in different provinces in South China transmitted by.peridomestic Ae. albopictus mosquitoes, diplaying Ae. aegypti, a fully domestic vector that transmits dengue worldwide. Rapid and uncontrolled urbanization is a characteristic change in developing countries, which impacts greatly on vector habitat, human lifestyle and transmission dynamics on dengue epidemics. In September 2010, an outbreak of dengue was detected in Dongguan, a city in Guangdong province characterized by its fast urbanization. An investigation was initiated to identify the cause, to describe the epidemical characteristics of the outbreak, and to implement control measures to stop the outbreak. This is the first report of dengue outbreak in Dongguan, even though dengue cases were documented before in this city. Methods Epidemiological data were obtained from local Center of Disease Control and prevention (CDC. Laboratory tests such as real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR, the virus cDNA sequencing, and Enzyme-Linked immunosorbent assay (ELISA were employed to identify the virus infection and molecular phylogenetic analysis was performed with MEGA5. The febrile cases were reported every day by the fever surveillance system. Vector control measures including insecticidal fogging and elimination of habitats of Ae. albopictus were used to control the dengue outbreak. Results The epidemiological studies results showed that this dengue outbreak was initiated by an imported case from Southeast Asia. The outbreak was characterized by 31 cases reported with an attack rate of 50.63 out of a population of 100,000. Ae. albopictus was the only vector species responsible for the outbreak. The virus c

Entomologic investigations during an outbreak of West Nile virus disease in Maricopa County, Arizona, 2010.

Science.gov (United States)

Godsey, Marvin S; Burkhalter, Kristen; Young, Ginger; Delorey, Mark; Smith, Kirk; Townsend, John; Levy, Craig; Mutebi, John-Paul

2012-12-01

Entomologic investigations were conducted during an intense outbreak of West Nile virus (WNV) disease in Maricopa County, Arizona during July 31-August 9, 2010. The investigations compared the East Valley outbreak area, and a demographically similar control area in northwestern metropolitan Phoenix where no human cases were reported. Five mosquito species were identified in each area, and species composition was similar in both areas. Significantly more Culex quinquefasciatus females were collected by gravid traps at Outbreak sites (22.2 per trap night) than at control sites (8.9 per trap night), indicating higher Cx. quinquefasciatus abundance in the outbreak area. Twenty-eight WNV TaqMan reverse transcription-polymerase chain reaction-positive mosquito pools were identified, including 24 of Cx. quinquefasciatus, 3 of Psorophora columbiae, and 1 of Culex sp. However, Cx. quinquefasciatus WNV infection rates did not differ between outbreak and control sites. At outbreak sites, 30 of 39 engorged Cx. quinquefasciatus had fed on birds, 8 of 39 on humans, and 1 of 39 on a lizard. At control sites, 20 of 20 identified blood meals were from birds. Data suggest that Cx. quinquefasciatus was the primary enzootic and epidemic vector of this outbreak. The most important parameters in the outbreak were vector abundance and blood meal analysis, which suggested more frequent contact between Cx. quinquefasciatus and human hosts in the outbreak area compared with the control area.

Causes of Outbreaks Associated with Drinking Water in the United States from 1971 to 2006

Science.gov (United States)

Craun, Gunther F.; Brunkard, Joan M.; Yoder, Jonathan S.; Roberts, Virginia A.; Carpenter, Joe; Wade, Tim; Calderon, Rebecca L.; Roberts, Jacquelin M.; Beach, Michael J.; Roy, Sharon L.

2010-01-01

Summary: Since 1971, the CDC, EPA, and Council of State and Territorial Epidemiologists (CSTE) have maintained the collaborative national Waterborne Disease and Outbreak Surveillance System (WBDOSS) to document waterborne disease outbreaks (WBDOs) reported by local, state, and territorial health departments. WBDOs were recently reclassified to better characterize water system deficiencies and risk factors; data were analyzed for trends in outbreak occurrence, etiologies, and deficiencies during 1971 to 2006. A total of 833 WBDOs, 577,991 cases of illness, and 106 deaths were reported during 1971 to 2006. Trends of public health significance include (i) a decrease in the number of reported outbreaks over time and in the annual proportion of outbreaks reported in public water systems, (ii) an increase in the annual proportion of outbreaks reported in individual water systems and in the proportion of outbreaks associated with premise plumbing deficiencies in public water systems, (iii) no change in the annual proportion of outbreaks associated with distribution system deficiencies or the use of untreated and improperly treated groundwater in public water systems, and (iv) the increasing importance of Legionella since its inclusion in WBDOSS in 2001. Data from WBDOSS have helped inform public health and regulatory responses. Additional resources for waterborne disease surveillance and outbreak detection are essential to improve our ability to monitor, detect, and prevent waterborne disease in the United States. PMID:20610821

Twin outbreak of cholera in rural North Karnataka, India

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Shuchismita Dey

2014-01-01

Full Text Available Background & objectives: Successive outbreaks of acute watery diarrhoea occurred in Talikoti and Harnal, located in Bijapur District of the southern Indian s0 tate of Karnataka, in July and August 2012, respectively. These outbreaks were investigated to identify the aetiology and epidemiology. Methods: Information was collected from the local population and health centres. Stool and water samples were collected from the admitted patients and their drinking water sources. Standard microbiological and PCR techniques were employed for isolation and characterization of the pathogen. Results: While 101 people (0.38% were affected in Talikoti, 200 (20.94% were affected in Harnal which is a small remote village. All age groups were affected but no death occurred. While the outbreak was smaller, longer and apparently spread by person to person contact in Talikoti, it occurred as a single source flash outbreak at Harnal. A single clone of toxigenic Vibrio cholerae O1 Ogawa biotype El Tor was isolated from the two stool samples obtained from Talikoti and subsequently from three of five stool samples obtained from Harnal indicating village to village spread of the aetiological agent. Striking similarity in antibiotic resistance profiles of these isolates with a particular strain isolated from the city of Belgaum, 250 km away, in 2010, prompted tracking the lineage of the V. cholerae isolates by DNA fingerprinting. Random amplified polymorphic DNA (RAPD fingerprinting assay helped confirm the origin of the incriminating strain to Belgaum. Interpretation & conclusions: Our study reported the first twin outbreak of cholera in two remote areas of Bijapur district, Karnataka, south India. It also indicated the need for immediate preparedness to deal with such emergencies.

What tree-ring reconstruction tells us about conifer defoliator outbreaks

Science.gov (United States)

Ann M. Lynch

2012-01-01

Our ability to understand the dynamics of forest insect outbreaks is limited by the lack of long-term data describing the temporal and spatial trends of outbreaks, the size and long life span of host plants, and the impracticability of manipulative experiments at relevant temporal and spatial scales. Population responses can be studied across varying site and stand...

Outbreak of Salmonella Oslo Infections Linked to Persian Cucumbers - United States, 2016.

Science.gov (United States)

Bottichio, Lyndsay; Medus, Carlota; Sorenson, Alida; Donovan, Danielle; Sharma, Reeti; Dowell, Natasha; Williams, Ian; Wellman, Allison; Jackson, Alikeh; Tolar, Beth; Griswold, Taylor; Basler, Colin

2016-12-30

In April 2016, PulseNet, the national molecular subtyping network for foodborne disease surveillance, detected a multistate cluster of Salmonella enterica serotype Oslo infections with an indistinguishable pulsed-field gel electrophoresis (PFGE) pattern (XbaI PFGE pattern OSLX01.0090).* This PFGE pattern was new in the database; no previous infections or outbreaks have been identified. CDC, state and local health and agriculture departments and laboratories, and the Food and Drug Administration (FDA) conducted epidemiologic, traceback, and laboratory investigations to identify the source of this outbreak. A total of 14 patients in eight states were identified, with illness onsets occurring during March 21-April 9, 2016. Whole genome sequencing, a highly discriminating subtyping method, was used to further characterize PFGE pattern OSLX01.0090 isolates. Epidemiologic evidence indicates Persian cucumbers as the source of Salmonella Oslo infections in this outbreak. This is the fourth identified multistate outbreak of salmonellosis associated with cucumbers since 2013. Further research is needed to understand the mechanism and factors that contribute to contamination of cucumbers during growth, harvesting, and processing to prevent future outbreaks.

Outbreaks, gene flow and effective population size in the migratory locust, Locusta migratoria: a regional-scale comparative survey.

Science.gov (United States)

Chapuis, Marie-Pierre; Loiseau, Anne; Michalakis, Yannis; Lecoq, Michel; Franc, Alex; Estoup, Arnaud

2009-03-01

The potential effect of population outbreaks on within and between genetic variation of populations in pest species has rarely been assessed. In this study, we compare patterns of genetic variation in different sets of historically frequently outbreaking and rarely outbreaking populations of an agricultural pest of major importance, the migratory locust, Locusta migratoria. We analyse genetic variation within and between 24 populations at 14 microsatellites in Western Europe, where only ancient and low-intensity outbreaks have been reported (non-outbreaking populations), and in Madagascar and Northern China, where frequent and intense outbreak events have been recorded over the last century (outbreaking populations). Our comparative survey shows that (i) the long-term effective population size is similar in outbreaking and non-outbreaking populations, as evidenced by similar estimates of genetic diversity, and (ii) gene flow is substantially larger among outbreaking populations than among non-outbreaking populations, as evidenced by a fourfold to 30-fold difference in FST values. We discuss the implications for population dynamics and the consequences for management strategies of the observed patterns of genetic variation in L. migratoria populations with contrasting historical outbreak frequency and extent.

Human resources for health: lessons from the cholera outbreak in Papua New Guinea.

Science.gov (United States)

Rosewell, Alexander; Bieb, Sibauk; Clark, Geoff; Miller, Geoff; MacIntyre, Raina; Zwi, Anthony

2013-01-01

Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals. Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services. We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt. Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population. In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency.

Longevity and fecundity of Dichroplus maculipennis (Orthoptera, Acrididae at non-outbreaking and outbreaking situations

Directory of Open Access Journals (Sweden)

Yanina Mariottini

2011-09-01

Full Text Available Dichroplus maculipennis is one of the most characteristic and damaging grasshopper species of Argentina, mainly in areas of the Pampas and Patagonia regions. We estimated and compared the longevity and fecundity of adult female D. maculipennis under controlled conditions (30ºC, 14L:10D, 40% RH from individuals collected as last instar nymphs (VI in the field and with a known recent history of low and high density conditions. Densities of D. maculipennis at the collecting sites were 0.95 individuals per m² in 2006 and 46 ind/m² in 2009, representing non-outbreaking and outbreaking situations, respectively. Adult female longevity in 2006 (67.96 ± 3.2 days was significantly higher (p 0.05. The fecundity curves showed that the highest values were at weeks 11 and 13 for the 2006 females, and at week 6 for those of 2009. Since the daily oviposition rate at low and high densities was not significantly different, the diminished fecundity rate at high density is attributable to their reduced longevity.

Norovirus outbreak associated with a hotel in the west of Ireland, 2006.

Science.gov (United States)

Michel, A; Fitzgerald, R; Whyte, D; Fitzgerald, A; Beggan, E; O'Connell, N; Greally, T

2007-07-01

An outbreak of gastrointestinal disease (nausea, vomiting or diarrhoea) occurred among a party of wedding guests, staff and other guests in a hotel in the west of Ireland, in October 2006. Upon notification, a multi-disciplinary outbreak control team was convened to investigate and control the outbreak. In all, 98 people were ascertained ill. The median duration of illness was 48 hours. The attack rate ranged between 48 and 85%. The hotel voluntarily notified health authorities and co-operated fully with investigation and control measures. Strict prevention and control measures were instituted promptly, including air ventilation, enhanced hand hygiene, isolation of cases, temporary "cooked food only", temporary alternative accommodation and specialised cleaning. Three cases of norovirus infection were laboratory-confirmed. There was no evidence of food- or water-borne transmission. Clinical and epidemiological findings indicated person-to-person transmission of norovirus. This report highlights the potential for large social gatherings to facilitate the spread of viral gastroenteritis by person-to-person transmission and via contaminated environment. Effective community management of this outbreak appears to have prevented its having an impact on local acute hospital services. The authors conclude that in addition to the existing national guidelines on the management of outbreaks of norovirus in healthcare settings, agreed guidelines for the management of norovirus outbreaks in the hotel and tourism industry are needed in Ireland.

EPIDEMIOLOGY OF CHOLERA OUTBREAK IN KAMPALA ...

African Journals Online (AJOL)

hi-tech

77 No. 7 July 2000. EPIDEMIOLOGY OF CHOLERA OUTBREAK IN KAMPALA, UGANDA ... spread much (106 cases in 1995), resulting in a low level of immunity ... An intensive social ... development of a network of community health workers,.

Carcass Management During Avian Influenza Outbreaks

Science.gov (United States)

This page on Avian Influenza (AI) describes carcass management during Avian Flu outbreaks, including who oversees carcass management, how they're managed, environmental concerns from carcass management, and disinfection. The page also describes what AI is.

Two outbreaks of classical swine fever in wild boar in France.

Science.gov (United States)

Pol, F; Rossi, S; Mesplède, A; Kuntz-Simon, G; Le Potier, M-F

2008-06-21

In 2002 and 2003, two successive outbreaks of classical swine fever were declared in wild boar in northern France. The first was in Moselle, near the town of Thionville and the border with Luxembourg, and the second was in the northern Vosges area, near the German border. The outbreaks were investigated by serological and virological diagnosis of dead or shot animals. Hunting restrictions were applied to limit the spread of the outbreaks. The virus was detected eight times between April and July 2002 in the Thionville area, an area well delimited by natural or artificial barriers such as rivers or highways. Cooperation between the authorities concerned was good, and hunting restrictions were applied for one year. No virus was detected after July 2002 and the Thionville outbreak was officially considered over in March 2005. In the northern Vosges the situation was different, with no barriers to animal movements, continuous forest, difficulties in establishing hunting restrictions in this huge area, and the circulation of the virus in Germany close to the frontier. Virus of a different strain from that isolated in the Thionville outbreak was still being isolated in the northern Vosges in 2004, and owing to the failure of the hunting restrictions, the French health authorities decided to vaccinate wild boar.

Effects of a Severe Mountain Pine Beetle Epidemic in Western Alberta, Canada under Two Forest Management Scenarios

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Richard R. Schneider

2010-01-01

Full Text Available We used a simulation model to investigate possible effects of a severe mountain pine beetle (Dendroctonus ponderosae Hopkins epidemic under two management scenarios in Alberta, Canada. Our simulated outbreak was based on the current epidemic in British Columbia, which may kill close to 80% of the province's pine volume. Our two management scenarios were conventional harvest and a pine-reduction strategy modeled on a component of Alberta's Mountain Pine Beetle Management Strategy. The pine strategy seeks to reduce the number of susceptible pine stands by 75% over the next 20 years through targeted harvesting by the forest industry. Our simulations showed that the pine strategy could not be effectively implemented, even if the onset of the beetle outbreak was delayed for 20 years. Even though we increased mill capacity by 20% and directed all harvesting to high volume pine stands during the pine strategy's surge cut, the amount of highly susceptible pine was reduced by only 43%. Additional pine volume remained within mixed stands that were not targeted by the pine strategy. When the outbreak occurred in each scenario, sufficient pine remained on the landscape for the beetle to cause the timber supply to collapse. Alternative management approaches and avenues for future research are discussed.

Outbreak of Clostridium difficile 027 in North Zealand, Denmark, 2008-2009

DEFF Research Database (Denmark)

Bacci, S; St-Martin, G; Olesen, B

2009-01-01

We report an outbreak of Clostridium difficile PCR ribotype 027 in Denmark. The outbreak includes to date 73 cases from the area north of Copenhagen, but there may be related cases elsewhere in Zealand. Most infections are healthcare-associated and in patients who previously received antibiotic...

Pandemic preparedness - Risk management and infection control for all respiratory infection outbreaks.

Science.gov (United States)

Nori, Annapurna; Williams, Mary-Anne

2009-11-01

There has been substantial effort and activity in regards to pandemic planning, preparedness and response, mainly in the realm of public health. However, general practitioners and other primary care providers are important players in the health response to a pandemic. To discuss the importance of general practice preparedness for managing respiratory infection outbreaks and to provide a model for the general practice response. Pandemic planning and preparedness in general practice is ultimately a crucial risk management exercise, the cornerstone of which is sound infection control. As planning will be significantly aided by, and should extend to, other respiratory outbreaks, we propose a framework for managing outbreaks of respiratory infections with a focus on planned, practised and habitual infection control measures, and a stepwise response according to the extent and severity of the outbreak.

Epidemiology and Management of the 2013-16 West African Ebola Outbreak.

Science.gov (United States)

Boisen, M L; Hartnett, J N; Goba, A; Vandi, M A; Grant, D S; Schieffelin, J S; Garry, R F; Branco, L M

2016-09-29

The 2013-16 West African Ebola outbreak is the largest, most geographically dispersed, and deadliest on record, with 28,616 suspected cases and 11,310 deaths recorded to date in Guinea, Liberia, and Sierra Leone. We provide a review of the epidemiology and management of the 2013-16 Ebola outbreak in West Africa aimed at stimulating reflection on lessons learned that may improve the response to the next international health crisis caused by a pathogen that emerges in a region of the world with a severely limited health care infrastructure. Surveillance efforts employing rapid and effective point-of-care diagnostics designed for environments that lack advanced laboratory infrastructure will greatly aid in early detection and containment efforts during future outbreaks. Introduction of effective therapeutics and vaccines against Ebola into the public health system and the biodefense armamentarium is of the highest priority if future outbreaks are to be adequately managed and contained in a timely manner.

[No best treatment for severe outbreaks: Maintenance, the key in colitis].

Science.gov (United States)

Sicilia, Beatriz

2011-12-01

Several drugs are currently available to maintain remission in patients who have responded after one or other type of induction therapy, depending on the initial severity of the outbreak. Salicylates are the drugs of choice to maintain remission after a mild-to-moderate outbreak controlled by salicylates or oral corticosteroids. To maintain remission after a severe outbreak or in patients with corticosteroid dependence or resistance, thiopurines are the drugs of choice. In patients who have failed to respond to thiopurines and in those with thiopurine intolerance, biological agents, mainly infliximab, can be used to maintain remission in patients after induction therapy with infliximab for a severe outbreak. However, these scenarios may not reflect reality of gastroenterologists' daily clinical practice. Treatment will therefore be based on the patient's individual characteristics (age, clinical course, previous treatment, adverse effects and personal preferences) as well as the physician's medical art. Copyright © 2011 Elsevier España, S.L.U. All rights reserved.

Outbreak tracking of Aleutian mink disease virus (AMDV) using partial NS1 gene sequencing

DEFF Research Database (Denmark)

Ryt-Hansen, Pia; Hjulsager, Charlotte Kristiane; Hagberg, E. E.

2017-01-01

. However, in 2015, several outbreaks of AMDV occurred at mink farms throughout Denmark, and the sources of these outbreaks were not known. Partial NS1 gene sequencing, phylogenetic analyses data were utilized along with epidemiological to determine the origin of the outbreaks. The phylogenetic analyses...... not be excluded. This study confirmed that partial NS1 sequencing can be used in outbreak tracking to determine major viral clusters of AMDV. Using this method, two new distinct AMDV clusters with low intra-cluster sequence diversity were identified, and epidemiological data helped to reveal possible ways...

Operational practices associated with foodborne disease outbreaks in the catering industry in England and Wales.

Science.gov (United States)

Jones, Sarah L; Parry, Sharon M; O'Brien, Sarah J; Palmer, Stephen R

2008-08-01

Catering businesses continue to be the most common setting for foodborne disease outbreaks. In a study of catering businesses in England and Wales, operational practices relating to the supply, preparation, and service of food in 88 businesses associated with outbreaks were compared with those practices at 88 control businesses. Operational practices did not differ significantly between case and control businesses but larger small medium-size enterprise (SME) businesses were more likely to be associated with foodborne disease outbreaks than were micro-SME businesses. Businesses associated with outbreaks of Salmonella infection were less likely to use local or national suppliers but instead used regional suppliers, especially for eggs. This practice was the only significantly independent operational practice associated with outbreaks of Salmonella infection. Regional egg suppliers also were more likely to be used by businesses associated with outbreaks attributed to food vehicles containing eggs. Businesses associated with egg-associated outbreaks were less likely to use eggs produced under an approved quality assurance scheme, suggesting that the underlying risk associated with using regional suppliers may relate to the use of contaminated eggs.

First reported chikungunya fever outbreak in the republic of Congo, 2011.

Directory of Open Access Journals (Sweden)

Nanikaly Moyen

Full Text Available Chikungunya is an Aedes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. We present a prospective clinical cohort study and a retrospective serological study relating to a CHIK outbreak, in the Republic of Congo in 2011.We analysed 317 suspected cases, of which 308 (97.2% lived in the city of Brazzaville (66.6% in the South area. Amongst them, 37 (11.7% were CHIKV+ve patients (i.e., biologically confirmed by a real-time RT-PCR assay, of whom 36 (97.3% had fever, 22 (66.7% myalgia and 32 (86.5% arthralgia. All tested negative for dengue. The distribution of incident cases within Brazzaville districts was compared with CHIKV seroprevalence before the outbreak (34.4% in 517 blood donors, providing evidence for previous circulation of CHIKV. We applied a CHIK clinical score to 126 patients recruited within the two first day of illness (including 28 CHIKV+ves (22.2% with sensitivity (78.6% and specificity (72.4% values comparing with those of the referent study in Reunion Island. The negative predictive value was high (92%, but the positive predictive value (45% indicate poor potential contribution to medical practice to identify CHIKV+ve patients in low prevalence outbreaks. However, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". The complete sequencing of a Congolase isolate (Brazza_MRS1 demonstrated belonging to the East/Central/South African lineage and was further used for producing a robust genome-scale CHIKV phylogenetic analysis.We describe the first Chikungunya outbreak declared in the Republic of Congo. The seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous CHIKV circulation. We suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in Central Africa for better understanding the environmental, microbiological and

Outbreaks of infectious intestinal disease associated with person to person spread in hotels and restaurants.

LENUS (Irish Health Repository)

McDonnell, R J

1995-09-15

Twenty-eight outbreaks of infectious intestinal disease, reported as being transmitted mainly by the person to person route, were identified in association with retail catering premises, such as hotels, restaurants, and public houses, in England and Wales between 1992 and 1994. Five thousand and forty-eight people were at risk in these outbreaks and 1234 were affected. Most of the outbreaks (over 90%) occurred in hotels. Small round structured viruses were the most commonly detected pathogens. Diarrhoea and vomiting were common symptoms and most of the outbreaks occurred in the summer months. Control measures to contain infectious individuals and improved hygiene measures are necessary to contain such outbreaks.

Protracted outbreak of S. Enteritidis PT 21c in a large Hamburg nursing home

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Domke Paul-Gerhard

2007-09-01

Full Text Available Abstract Background During August 2006, a protracted outbreak of Salmonella (S. Enteritidis infections in a large Hamburg nursing home was investigated. Methods A site visit of the home was conducted and food suppliers' premises tested for Salmonella. Among nursing home residents a cohort study was carried out focusing on foods consumed in the three days before the first part of the outbreak. Instead of relying on residents' memory, data from the home's patient food ordering system was used as exposure data. S. Enteritidis isolates from patients and suspected food vehicles were phage typed and compared. Results Within a population of 822 nursing home residents, 94 case patients among residents (1 fatality and 17 among staff members were counted 6 through 29 August. The outbreak peaked 7 through 9 August, two days after a spell of very warm summer weather. S. Enteritidis was consistently recovered from patients' stools throughout the outbreak. Among the food items served during 5 through 7 August, the cohort study pointed to afternoon cake on all three days as potential risk factors for disease. Investigation of the bakery supplying the cake yielded S. Enteritidis from cakes sampled 31 August. Comparison of the isolates by phage typing demonstrated both isolates from patients and the cake to be the exceedingly rare phage type 21c. Conclusion Cake (various types served on various days contaminated with S. Enteritidis were the likely vehicle of the outbreak in the nursing home. While the cakes were probably contaminated with low pathogen dose throughout the outbreak period, high ambient summer temperatures and failure to keep the cake refrigerated led to high pathogen dose in cake on some days and in some of the housing units. This would explain the initial peak of cases, but also the drawn out nature of the outbreak with cases until the end of August. Suggestions are made to nursing homes, aiding in outbreak prevention. Early outbreak detection is

Water-borne epidemic outbreaks; Brotes epidemicos de transmision hidrica

Energy Technology Data Exchange (ETDEWEB)

Ciranda Larrea, F.B.; Hidalgo Garcia, E.; Peiro Callizo, E.F.; Herrero Alana, G.

1995-12-31

The control of water-transmitted infections is one of the key aims of any Public Heath-Care System. For this paper a descriptive epidemiologic analysis has been performed using data obtained through normalized forms as well as Annual Reports of Epidemiology Units and Veterinary Inspection Records. A total of 22 outbreaks have been recorded in the period of reference. Those outbreaks affected 2.263 people. The attack-rate was of 99 people affected for each 1000 ar risk. The main agents turned out to be Norwalk virus, Rotavirus and A-Hepatitis virus. The most important risk factor was undoubtedly the ingestion of untreated or not properly treated water. The improvement of water treatment and distribution systems, the increase in the population being supplied with potable water, along with the ease of the drought have caused a significant drop in the number of water-transmitted outbreaks. (Author)

Post-Ebola Measles Outbreak in Lola, Guinea, January-June 2015(1).

Science.gov (United States)

Suk, Jonathan E; Paez Jimenez, Adela; Kourouma, Mamadou; Derrough, Tarik; Baldé, Mamadou; Honomou, Patric; Kolie, Nestor; Mamadi, Oularé; Tamba, Kaduono; Lamah, Kalaya; Loua, Angelo; Mollet, Thomas; Lamah, Molou; Camara, Amara Nana; Prikazsky, Vladimir

2016-06-01

During public health crises such as the recent outbreaks of Ebola virus disease in West Africa, breakdowns in public health systems can lead to epidemics of vaccine-preventable diseases. We report here on an outbreak of measles in the prefecture of Lola, Guinea, which started in January 2015.

First outbreak with MRSA in a danish neonatal intensive care unit

DEFF Research Database (Denmark)

Ramsing, Benedicte Grenness Utke; Arpi, Magnus; Andersen, Erik Arthur

2013-01-01

The purpose of the study was to describe demographic and clinical characteristics and outbreak handling of a large methicillin-resistant Staphylococcus aureus (MRSA) outbreak in a neonatal intensive care unit (NICU) in Denmark June 25(th)-August 8(th) 2008, and to identify risk factors for MRSA t...

Diarrhoeal disease outbreak in a rural area of Karnataka

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Bhavana R Hiremath

2015-12-01

Full Text Available Background: Acute diarrhoea is the passage of 3 or more loose or watery stools in the past 24 hours with or without dehydration. Owing to WASH strategy (Water, Sanitation and Hygiene the burden of diarrheal diseases has seen a tremendous decline over the past 2 decades. Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio Cholerae. Objectives: 1. To document the factors responsible for the outbreak. 2. To provide recommendations for prevention and control of such outbreaks in future. Methods: After receiving verbal information from district office regarding outbreak of diarrhoeal disease (cholera in a town of Bijapur district, we independently conducted a cross sectional study in the affected area and collected information regarding no. of people affected since the outbreak, their age and sex distribution. A total of 3802 people were interviewed using a predesigned questionnaire on 28th and 29th July, 2012. We also conducted environmental investigation regarding the source of contamination and collected 2 water samples from drinking water source. Results: All the cases were clustered in the five streets, which were consuming water from contaminated two water tanks. A total of 121 cases of diarrhoea were identified affecting 3.18% of the population. Attack rate of cholera was highest (4.5% in 25-34 years age group followed by 4.22% in 15-24 years age group. Attack rates was higher among females (3.4% compared to males (2.9%. Laboratory report stated that water samples were unfit for drinking purpose. V. Cholera (Ogawa serotype was isolated from water sample. Conclusion: Consumption of contaminated water from a newly dug bore-well had led to the diarrhea outbreak. Lack of sanitation and hygiene had worsened the situation.

Shigellosis outbreak at Addis Ababa University: March-April 2010.

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Aragaw, Mer'awi; Tafese, Tilahun; Beyene, Zayeda; Hailemariam, Zegeye; Azaze, Aklilu; Luce, Richard; Addissie, Adamu

2011-10-01

Between 2006 and 2008, there have been various reports of diarrhea with blood in Ethiopia and also reports of Shigelloses outbreaks in some parts of the country. In March 2010, Addis Ababa University (AAU) Technology Campus reported occurrence of an outbreak of diarrheal illness among students. The study was conducted to identify the causative agent and the possible source of the diarrhea outbreak that occurred at Technology Campus. Active case finding and review of medical records were undertaken to characterize the outbreak. The investigation consisted of a case-control study with laboratory testing and environmental assessment. A structured questionnaire was used to collect data. Data were analyzed using Epi-info (v3.3.2). A total of 104 suspected cases were identified, based on the case definition, with an attack rate of 6.8%. Stool culture confirmed Shigella flexneri species in 5/11 (45%) of specimens tested. Risk factors associated with illness included eating specific foods at specific meal times. Food items served on Friday March 26, at lunch time (OR: 3.59, CI: 1.0- 12.7, p = 0.04) and on Saturday March 27, during dinner (OR: 2.89 CI: 1.0- 8.2, p = 0.04) were significantly associated with increased odds of illness. Water stored in a tank in the cafeteria had evidence of fecal contamination (fecal coliform count > 161 Mpn /100ml) and the hygiene and sanitary conditions in the cafeteria, kitchen, living area were unsatisfactory. Food-borne transmission and water contamination were suspected as the sources of infection. Regular supervision and inspection of the campus' food handling facilities and practices were recommended to improve food hygiene and sanitation. Improved water storage, correcting periodic water shortages in the latrine facility and promotion of hand washing could reduce potential future outbreaks.

Diarrhoeal disease outbreak in a rural area of Karnataka

Directory of Open Access Journals (Sweden)

Bhavana R Hiremath

2015-12-01

Full Text Available Background: Acute diarrhoea is the passage of 3 or more loose or watery stools in the past 24 hours with or without dehydration. Owing to WASH strategy (Water, Sanitation and Hygiene the burden of diarrheal diseases has seen a tremendous decline over the past 2 decades. Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio Cholerae. Objectives: 1. To document the factors responsible for the outbreak. 2. To provide recommendations for prevention and control of such outbreaks in future. Methods: After receiving verbal information from district office regarding outbreak of diarrhoeal disease (cholera in a town of Bijapur district, we independently conducted a cross sectional study in the affected area and collected information regarding no. of people affected since the outbreak, their age and sex distribution. A total of 3802 people were interviewed using a predesigned questionnaire on 28th and 29th July, 2012. We also conducted environmental investigation regarding the source of contamination and collected 2 water samples from drinking water source. Results: All the cases were clustered in the five streets, which were consuming water from contaminated two water tanks. A total of 121 cases of diarrhoea were identified affecting 3.18% of the population. Attack rate of cholera was highest (4.5% in 25-34 years age group followed by 4.22% in 15-24 years age group. Attack rates was higher among females (3.4% compared to males (2.9%. Laboratory report stated that water samples were unfit for drinking purpose. V. Cholera (Ogawa serotype was isolated from water sample. Conclusion: Consumption of contaminated water from a newly dug bore-well had led to the diarrhea outbreak. Lack of sanitation and hygiene had worsened the situation.

Outbreak of Enterovirus - 71 Meningitis in Calicut

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CK Sasidharan

2016-04-01

Full Text Available Objective: Enterovirus 71(EV 71 causes wide spectrum of infections ranging from asymptomatic conditions to clinical syndromes like diarrhea, rash, hand-foot-and mouth disease (HFMD, herpangina, aseptic meningitis, encephalitis, myocarditis, acute flaccid paralysis, bulbar and brainstem encephalitis Guillain Barre syndrome, pulmonary haemorrhage. This study deals with an outbreak of aseptic meningitis in children caused by EV 71 virus. Methods: The authors report an outbreak of aseptic meningitis in children in and around Calicut in June 2008. Clinical and laboratory study was done in collaboration with National Centre for Disease Control, New Delhi. 149 children with aseptic meningitis were studied and followed up from June 2008 to May 2009. Result: All children had clinical features suggestive of aseptic meningitis and serology showed the rising antibody titre against EV 71 virus infection. CSF analysis also showed four fold rise in antibodies in one and ≥ 1:2 neutralising antibodies titer against EV- 71 in four samples indicating meningitis due to EV-71. Conclusion: EV 71 was identified as the causative agent of the outbreak of aseptic meningitis in the study and the fact that the EV 71 infection has evolved from minor illness like HFMD to major illness like aseptic meningitis from the same locality is truly alarming.

Strategies for Early Outbreak Detection of Malaria in the Amhara Region of Ethiopia

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Nekorchuk, D.; Gebrehiwot, T.; Mihretie, A.; Awoke, W.; Wimberly, M. C.

2017-12-01

Traditional epidemiological approaches to early detection of disease outbreaks are based on relatively straightforward thresholds (e.g. 75th percentile, standard deviations) estimated from historical case data. For diseases with strong seasonality, these can be modified to create separate thresholds for each seasonal time step. However, for disease processes that are non-stationary, more sophisticated techniques are needed to more accurately estimate outbreak threshold values. Early detection for geohealth-related diseases that also have environmental drivers, such as vector-borne diseases, may also benefit from the integration of time-lagged environmental data and disease ecology models into the threshold calculations. The Epidemic Prognosis Incorporating Disease and Environmental Monitoring for Integrated Assessment (EPIDEMIA) project has been integrating malaria case surveillance with remotely-sensed environmental data for early detection, warning, and forecasting of malaria epidemics in the Amhara region of Ethiopia, and has five years of weekly time series data from 47 woredas (districts). Efforts to reduce the burden of malaria in Ethiopia has been met with some notable success in the past two decades with major reduction in cases and deaths. However, malaria remains a significant public health threat as 60% of the population live in malarious areas, and due to the seasonal and unstable transmission patterns with cyclic outbreaks, protective immunity is generally low which could cause high morbidity and mortality during the epidemics. This study compared several approaches for defining outbreak thresholds and for identifying a potential outbreak based on deviations from these thresholds. We found that model-based approaches that accounted for climate-driven seasonality in malaria transmission were most effective, and that incorporating a trend component improved outbreak detection in areas with active malaria elimination efforts. An advantage of these early

Polio infrastructure strengthened disease outbreak preparedness and response in the WHO African Region.

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Kouadio, Koffi; Okeibunor, Joseph; Nsubuga, Peter; Mihigo, Richard; Mkanda, Pascal

2016-10-10

The continuous deployments of polio resources, infrastructures and systems for responding to other disease outbreaks in many African countries has led to a number of lessons considered as best practice that need to be documented for strengthening preparedness and response activities in future outbreaks. We reviewed and documented the influence of polio best practices in outbreak preparedness and response in Angola, Nigeria and Ethiopia. Data from relevant programmes of the WHO African Region were also analyzed to demonstrate clearly the relative contributions of PEI resources and infrastructure to effective disease outbreak preparedness and response. Polio resources including, human, financial, and logistic, tool and strategies have tremendously contributed to responding to diseases outbreaks across the African region. In Angola, Nigeria and Ethiopia, many disease epidemics including Marburg Hemorrhagic fever, Dengue fever, Ebola Virus Diseases (EVD), Measles, Anthrax and Shigella have been controlled using existing polio Eradication Initiatives resources. Polio staffs are usually deployed in occasions to supports outbreak response activities (coordination, surveillance, contact tracing, case investigation, finance, data management, etc.). Polio logistics such vehicles, laboratories were also used in the response activities to other infectious diseases. Many polio tools including micro planning, dashboard, guidelines, SOPs on preparedness and response have also benefited to other epidemic-prone diseases. The Countries' preparedness and response plan to WPV importation as well as the Polio Emergency Operation Center models were successfully used to develop, strengthen and respond to many other diseases outbreak with the implication of partners and the strong leadership and ownership of governments. This review has important implications for WHO/AFRO initiative to strengthening and improving disease outbreak preparedness and responses in the African Region in respect

Why has the Ebola outbreak in West Africa been so challenging to control?

Science.gov (United States)

Semalulu, T; Wong, G; Kobinger, G; Huston, P

2014-08-14

West Africa is in the midst of the largest Ebola outbreak ever; there have been over 1000 deaths and many new cases are reported each day. The World Health Organization (WHO) declared it an outbreak in March 2014 and on August 6, 2014 the WHO declared the outbreak a public health emergency of international concern. Based on the number of deaths and total number of cases reported to the WHO as of August 11, 2014, the current outbreak has an overall mortality rate of 55%. Outbreak control measures against Ebola virus disease are effective. Why then, has this outbreak been so challenging to control? Ebola is transmitted through bodily fluids and immediately attacks the immune system, then progressively attacks the major organs and the lining of blood vessels. Sierra Leone, Guinea and Liberia are small countries that have limited resources to respond to prolonged outbreaks, especially in rural areas. This has been made more challenging by the fact that health care workers are at risk of contracting Ebola virus disease. Treatment to date has been supportive, not curative and outbreak control strategies have been met with distrust due to fear and misinformation. However, important progress is being made. The international response to Ebola is gaining momentum, communication strategies have been developed to address the fear and mistrust, and promising treatments are under development, including a combination of three monoclonal antibodies that has been administered to two American Ebola infected health care workers. The National Microbiology Laboratory of the Public Health Agency of Canada (PHAC) has been supporting laboratory diagnostic efforts in West Africa and PHAC has been working with the provinces and territories and key stakeholders to ensure Canada is prepared for a potential Ebola importation.

Hepatitis A outbreak in Ba subdivision, Fiji, October–December 2013

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Aneley Getahun

2015-06-01

Full Text Available Objective: A cluster of suspected hepatitis A cases was notified to the Fiji Ministry of Health on 22 October 2013. An outbreak investigation team was mobilized to confirm the existence of an outbreak of hepatitis A and advise appropriate public health interventions. Methods: A case definition for the outbreak investigation was established, and standardized data collection tools were used to collect information on clinical presentation and risk factors. An environmental assessment was also conducted. Results: There were 160 clinical cases of hepatitis A of which 15 were laboratory-confirmed. The attack rate was 349 per 10 000 population in the Nukuloa nursing zone; there were no reported deaths. Residents of the Nukuloa settlement were 6.6 times more likely to present with symptomatic hepatitis A infection (95% confidence interval: 3.8–12.6 compared with residents of another village with a different water supply. Discussion: This is the first significant hepatitis A outbreak documented in Ba subdivision and possibly in Fiji. Enhanced surveillance of hepatitis A may reveal other clusters in the country. Improving the primary water source dramatically reduced the occurance of disease in the affected community and adjacent areas.

Hepatitis A outbreak in Ba subdivision, Fiji, October-December 2013.

Science.gov (United States)

Getahun, Aneley; Rafai, Eric; Tolosa, Maria Ximena; Dawainavesi, Akanisi; Tabua, Anaseini Maisema; Tabua, Josefa

2015-01-01

A cluster of suspected hepatitis A cases was notified to the Fiji Ministry of Health on 22 October 2013. An outbreak investigation team was mobilized to confirm the existence of an outbreak of hepatitis A and advise appropriate public health interventions. A case definition for the outbreak investigation was established, and standardized data collection tools were used to collect information on clinical presentation and risk factors. An environmental assessment was also conducted. There were 160 clinical cases of hepatitis A of which 15 were laboratory-confirmed. The attack rate was 349 per 10,000 population in the Nukuloa nursing zone; there were no reported deaths. Residents of the Nukuloa settlement were 6.6 times more likely to present with symptomatic hepatitis A infection (95% confidence interval: 3.8-12.6) compared with residents of another village with a different water supply. This is the first significant hepatitis A outbreak documented in Ba subdivision and possibly in Fiji. Enhanced surveillance of hepatitis A may reveal other clusters in the country. Improving the primary water source dramatically reduced the occurance of disease in the affected community and adjacent areas.

Lungworm outbreaks in adult dairy cows: estimating economic losses and lessons to be learned.

Science.gov (United States)

Holzhauer, M; van Schaik, G; Saatkamp, H W; Ploeger, H W

2011-11-05

Two lungworm outbreaks in dairy herds were investigated in order to estimate the resulting economic costs. On the two farms, with 110 and 95 cows, total costs were estimated at €159 and €167 per cow, respectively. Overall, milk production reduced by 15 to 20 per cent during the outbreaks. Five cows died on one farm, while on the other farm seven cows died as a result of the lungworm outbreak. On one farm, 51.7 per cent of the total costs was due to reduced milk production and 33.1 per cent was due to disposal of dead animals. On the other farm, it was 36.3 and 50.9 per cent, respectively. The remaining 13 to 15 per cent of the total costs were due to extra inseminations, laboratory diagnosis and treatments. The history and development of the outbreaks are described. One lesson from these outbreaks is that recognising that potentially lungworm-naïve animals are to be introduced into the adult herd allows for timely measures (for example, vaccination) to prevent a lungworm outbreak.

A Framework for Responding to Coral Disease Outbreaks that Facilitates Adaptive Management

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Beeden, Roger; Maynard, Jeffrey A.; Marshall, Paul A.; Heron, Scott F.; Willis, Bette L.

2012-01-01

Predicted increases in coral disease outbreaks associated with climate change have implications for coral reef ecosystems and the people and industries that depend on them. It is critical that coral reef managers understand these implications and have the ability to assess and reduce risk, detect and contain outbreaks, and monitor and minimise impacts. Here, we present a coral disease response framework that has four core components: (1) an early warning system, (2) a tiered impact assessment program, (3) scaled management actions and (4) a communication plan. The early warning system combines predictive tools that monitor the risk of outbreaks of temperature-dependent coral diseases with in situ observations provided by a network of observers who regularly report on coral health and reef state. Verified reports of an increase in disease prevalence trigger a tiered response of more detailed impact assessment, targeted research and/or management actions. The response is scaled to the risk posed by the outbreak, which is a function of the severity and spatial extent of the impacts. We review potential management actions to mitigate coral disease impacts and facilitate recovery, considering emerging strategies unique to coral disease and more established strategies to support reef resilience. We also describe approaches to communicating about coral disease outbreaks that will address common misperceptions and raise awareness of the coral disease threat. By adopting this framework, managers and researchers can establish a community of practice and can develop response plans for the management of coral disease outbreaks based on local needs. The collaborations between managers and researchers we suggest will enable adaptive management of disease impacts following evaluating the cost-effectiveness of emerging response actions and incrementally improving our understanding of outbreak causation.

Comparison of norovirus RNA levels in outbreak-related oysters with background environmental levels.

Science.gov (United States)

Lowther, James A; Gustar, Nicole E; Hartnell, Rachel E; Lees, David N

2012-02-01

Norovirus is the principal agent of bivalve shellfish-associated gastroenteric illness worldwide. Numerous studies using PCR have demonstrated norovirus contamination in a significant proportion of both oyster and other bivalve shellfish production areas and ready-to-eat products. By comparison, the number of epidemiologically confirmed shellfish-associated outbreaks is relatively low. This suggests that factors other than the simple presence or absence of virus RNA are important contributors to the amount of illness reported. This study compares norovirus RNA levels in oyster samples strongly linked to norovirus or norovirus-type illness with the levels typically found in commercial production areas (non-outbreak-related samples). A statistically significant difference between norovirus levels in the two sets of samples was observed. The geometric mean of the levels in outbreak samples (1,048 copies per g) was almost one order of magnitude higher than for positive non-outbreak-related samples (121 copies per g). Further, while none of the outbreak-related samples contained fewer than 152 copies per g, the majority of positive results for non-outbreak-related samples was below this level. These observations support the concept of a dose-response for norovirus RNA levels in shellfish and could help inform the establishment of threshold criteria for risk management.

Spatial diffusion of influenza outbreak-related climate factors in Chiang Mai Province, Thailand.

Science.gov (United States)

Nakapan, Supachai; Tripathi, Nitin Kumar; Tipdecho, Taravudh; Souris, Marc

2012-10-24

Influenza is one of the most important leading causes of respiratory illness in the countries located in the tropical areas of South East Asia and Thailand. In this study the climate factors associated with influenza incidence in Chiang Mai Province, Northern Thailand, were investigated. Identification of factors responsible for influenza outbreaks and the mapping of potential risk areas in Chiang Mai are long overdue. This work examines the association between yearly climate patterns between 2001 and 2008 and influenza outbreaks in the Chiang Mai Province. The climatic factors included the amount of rainfall, percent of rainy days, relative humidity, maximum, minimum temperatures and temperature difference. The study develops a statistical analysis to quantitatively assess the relationship between climate and influenza outbreaks and then evaluate its suitability for predicting influenza outbreaks. A multiple linear regression technique was used to fit the statistical model. The Inverse Distance Weighted (IDW) interpolation and Geographic Information System (GIS) techniques were used in mapping the spatial diffusion of influenza risk zones. The results show that there is a significance correlation between influenza outbreaks and climate factors for the majority of the studied area. A statistical analysis was conducted to assess the validity of the model comparing model outputs and actual outbreaks.

Spatial Diffusion of Influenza Outbreak-Related Climate Factors in Chiang Mai Province, Thailand

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Marc Souris

2012-10-01

Full Text Available Influenza is one of the most important leading causes of respiratory illness in the countries located in the tropical areas of South East Asia and Thailand. In this study the climate factors associated with influenza incidence in Chiang Mai Province, Northern Thailand, were investigated. Identification of factors responsible for influenza outbreaks and the mapping of potential risk areas in Chiang Mai are long overdue. This work examines the association between yearly climate patterns between 2001 and 2008 and influenza outbreaks in the Chiang Mai Province. The climatic factors included the amount of rainfall, percent of rainy days, relative humidity, maximum, minimum temperatures and temperature difference. The study develops a statistical analysis to quantitatively assess the relationship between climate and influenza outbreaks and then evaluate its suitability for predicting influenza outbreaks. A multiple linear regression technique was used to fit the statistical model. The Inverse Distance Weighted (IDW interpolation and Geographic Information System (GIS techniques were used in mapping the spatial diffusion of influenza risk zones. The results show that there is a significance correlation between influenza outbreaks and climate factors for the majority of the studied area. A statistical analysis was conducted to assess the validity of the model comparing model outputs and actual outbreaks.

[EPIDEMIOLOGIC FEATURES OFNOROVIRUS INFECTION OUTBREAK IN THE REPUBLIC OF NORTH OSSETIA-ALANIA].

Science.gov (United States)

Maletskaya, O V; Tibilov, A G; Prislegina, D A; Gazieva, G K; Otaraeva, N I; Volynkina, A S; Saveliev, V N; Lyamkin, G I; Zaitsev, A A; Kulichenko, A N

2016-01-01

Analysis of epidemiologic features of a norovirus outbreak in Alagir city of the Republic of North Ossetia-Alania and effectiveness of measures of its liquidation. Data from maps-schemes of water supply system of Alagir city and statistical documentation of Centre of Hygiene and Epidemiology in the Republic of North Ossetia-Alania were used in the study. Indication of norovirus in clinical material and water samples was carried out bypolymerase chain reaction method. Etiological agent of outbreak disease was established--genotype II norovirus. Realization of fecal-oral mechanisms of water transmission pathway of the causative agent of norovirus infection was detected. Conditions facilitating emergence and development of the indicated outbreak were determined--non-satisfactory sanitary-technical condition of water. supply system of the city. The studied water outbreak of norovirus infection was caused by GII.17 genotype virus, that currently gradually displaces GII.IV genotype, and was characterized by an intensive start, involvement of all population age groups into the epidemic process (with primary infection of adults), low family focality, predominance of average severity disease forms in the clinical presentation. The counter-epidemic measures carried out ensured rapid localization and liquidation of the norovirus infection outbreak.

Lethal canine distemper virus outbreak in cynomolgus monkeys in Japan in 2008.

Science.gov (United States)

Sakai, Kouji; Nagata, Noriyo; Ami, Yasushi; Seki, Fumio; Suzaki, Yuriko; Iwata-Yoshikawa, Naoko; Suzuki, Tadaki; Fukushi, Shuetsu; Mizutani, Tetsuya; Yoshikawa, Tomoki; Otsuki, Noriyuki; Kurane, Ichiro; Komase, Katsuhiro; Yamaguchi, Ryoji; Hasegawa, Hideki; Saijo, Masayuki; Takeda, Makoto; Morikawa, Shigeru

2013-01-01

Canine distemper virus (CDV) has recently expanded its host range to nonhuman primates. A large CDV outbreak occurred in rhesus monkeys at a breeding farm in Guangxi Province, China, in 2006, followed by another outbreak in rhesus monkeys at an animal center in Beijing in 2008. In 2008 in Japan, a CDV outbreak also occurred in cynomolgus monkeys imported from China. In that outbreak, 46 monkeys died from severe pneumonia during a quarantine period. A CDV strain (CYN07-dV) was isolated in Vero cells expressing dog signaling lymphocyte activation molecule (SLAM). Phylogenic analysis showed that CYN07-dV was closely related to the recent CDV outbreaks in China, suggesting continuing chains of CDV infection in monkeys. In vitro, CYN07-dV uses macaca SLAM and macaca nectin4 as receptors as efficiently as dog SLAM and dog nectin4, respectively. CYN07-dV showed high virulence in experimentally infected cynomolgus monkeys and excreted progeny viruses in oral fluid and feces. These data revealed that some of the CDV strains, like CYN07-dV, have the potential to cause acute systemic infection in monkeys.

Modeling Estimated Personnel Needs for a Potential Foot and Mouth Disease Outbreak

Energy Technology Data Exchange (ETDEWEB)

Simmons, K; Hullinger, P

2008-01-29

Foot and Mouth disease (FMD) is a highly infectious and contagious viral disease affecting cloven-hoofed livestock that was last detected in the United States (US) in 1929. The prevalence of FMD in other countries, as well as the current potential for this virus to be used as a form of agroterrorism, has made preparations for a potential FMD outbreak a national priority. To assist in the evaluation of national preparedness, all 50 states were surveyed via e-mail, telephone and web search to obtain emergency response plans for FMD or for foreign animal diseases in general. Information from 33 states was obtained and analyzed for estimates of personnel resources needed to respond to an outbreak. These estimates were consolidated and enhanced to create a tool that could be used by individual states to better understand the personnel that would be needed to complete various tasks over time during an outbreak response. The estimates were then coupled, post-processing, to the output from FMD outbreaks simulated in California using the Multiscale Epidemiological/Economic Simulation and Analysis (MESA) model at Lawrence Livermore National Laboratory to estimate the personnel resource demands, by task, over the course of an outbreak response.

Economic and health impacts associated with a Salmonella Typhimurium drinking water outbreak-Alamosa, CO, 2008.

Directory of Open Access Journals (Sweden)

Elizabeth Ailes

Full Text Available In 2008, a large Salmonella outbreak caused by contamination of the municipal drinking water supply occurred in Alamosa, Colorado. The objectives of this assessment were to determine the full economic costs associated with the outbreak and the long-term health impacts on the community of Alamosa. We conducted a postal survey of City of Alamosa (2008 population: 8,746 households and businesses, and conducted in-depth interviews with local, state, and nongovernmental agencies, and City of Alamosa healthcare facilities and schools to assess the economic and long-term health impacts of the outbreak. Twenty-one percent of household survey respondents (n = 369/1,732 reported diarrheal illness during the outbreak. Of those, 29% (n = 108 reported experiencing potential long-term health consequences. Most households (n = 699/771, 91% reported municipal water as their main drinking water source at home before the outbreak; afterwards, only 30% (n = 233 drank unfiltered municipal tap water. The outbreak's estimated total cost to residents and businesses of Alamosa using a Monte Carlo simulation model (10,000 iterations was approximately $1.5 million dollars (range: $196,677-$6,002,879, and rose to $2.6 million dollars (range: $1,123,471-$7,792,973 with the inclusion of outbreak response costs to local, state and nongovernmental agencies and City of Alamosa healthcare facilities and schools. This investigation documents the significant economic and health impacts associated with waterborne disease outbreaks and highlights the potential for loss of trust in public water systems following such outbreaks.

Economic and health impacts associated with a Salmonella Typhimurium drinking water outbreak-Alamosa, CO, 2008.

Science.gov (United States)

Ailes, Elizabeth; Budge, Philip; Shankar, Manjunath; Collier, Sarah; Brinton, William; Cronquist, Alicia; Chen, Melissa; Thornton, Andrew; Beach, Michael J; Brunkard, Joan M

2013-01-01

In 2008, a large Salmonella outbreak caused by contamination of the municipal drinking water supply occurred in Alamosa, Colorado. The objectives of this assessment were to determine the full economic costs associated with the outbreak and the long-term health impacts on the community of Alamosa. We conducted a postal survey of City of Alamosa (2008 population: 8,746) households and businesses, and conducted in-depth interviews with local, state, and nongovernmental agencies, and City of Alamosa healthcare facilities and schools to assess the economic and long-term health impacts of the outbreak. Twenty-one percent of household survey respondents (n = 369/1,732) reported diarrheal illness during the outbreak. Of those, 29% (n = 108) reported experiencing potential long-term health consequences. Most households (n = 699/771, 91%) reported municipal water as their main drinking water source at home before the outbreak; afterwards, only 30% (n = 233) drank unfiltered municipal tap water. The outbreak's estimated total cost to residents and businesses of Alamosa using a Monte Carlo simulation model (10,000 iterations) was approximately $1.5 million dollars (range: $196,677-$6,002,879), and rose to $2.6 million dollars (range: $1,123,471-$7,792,973) with the inclusion of outbreak response costs to local, state and nongovernmental agencies and City of Alamosa healthcare facilities and schools. This investigation documents the significant economic and health impacts associated with waterborne disease outbreaks and highlights the potential for loss of trust in public water systems following such outbreaks.

Foodborne Outbreaks Reported to the U.S. Food Safety and Inspection Service, Fiscal Years 2007 through 2012.

Science.gov (United States)

Robertson, Kis; Green, Alice; Allen, Latasha; Ihry, Timothy; White, Patricia; Chen, Wu-San; Douris, Aphrodite; Levine, Jeoffrey

2016-03-01

The U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) works closely with federal, state, and local public health partners to investigate foodborne illness outbreaks associated with its regulated products. To provide insight into outbreaks associated with meat and poultry, outbreaks reported to FSIS during fiscal years 2007 through 2012 were evaluated. Outbreaks were classified according to the strength of evidence linking them to an FSIS-regulated product and by their epidemiological, etiological, and vehicle characteristics. Differences in outbreak characteristics between the period 2007 through 2009 and the period 2010 through 2012 were assessed using a chi-square test or Mann-Whitney U test. Of the 163 reported outbreaks eligible for analysis, 89 (55%) were identified as possibly linked to FSIS-regulated products and 74 (45%) were definitively linked to FSIS-regulated products. Overall, these outbreaks were associated with 4,132 illnesses, 772 hospitalizations, and 19 deaths. Shiga toxin-producing Escherichia coli was associated with the greatest proportion of reported outbreaks (55%), followed by Salmonella enterica (34%) and Listeria monocytogenes (7%). Meat and poultry products commercially sold as raw were linked to 125 (77%) outbreaks, and of these, 105 (80%) involved beef. Over the study period, the number of reported outbreaks definitively linked to FSIS-regulated products (P = 0.03) declined, while the proportion of culture-confirmed cases (P = 0.0001) increased. Our findings provide insight into the characteristics of outbreaks associated with meat and poultry products.

Spray deposition from ground-based applications of carbaryl to protect individual trees from bark beetle attack.

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Fettig, Christopher J; Munson, A Steven; McKelvey, Stephen R; Bush, Parshall B; Borys, Robert R

2008-01-01

Bark beetles (Coleoptera: Curculionidae, Scolytinae) are recognized as the most important tree mortality agent in western coniferous forests. A common method of protecting trees from bark beetle attack is to saturate the tree bole with carbaryl (1-naphthyl methylcarbamate) using a hydraulic sprayer. In this study, we evaluate the amount of carbaryl drift (ground deposition) occurring at four distances from the tree bole (7.6, 15.2, 22.9, and 38.1 m) during conventional spray applications for protecting individual lodgepole pine (Pinus contorta Dougl. ex Loud.) from mountain pine beetle (Dendroctonus ponderosae Hopkins) attack and Engelmann spruce (Picea engelmannii Parry ex Engelm.) from spruce beetle (D. rufipennis [Kirby]) attack. Mean deposition (carbaryl + alpha-naphthol) did not differ significantly among treatments (nozzle orifices) at any distance from the tree bole. Values ranged from 0.04 +/- 0.02 mg carbaryl m(-2) at 38.1 m to 13.30 +/- 2.54 mg carbaryl m(-2) at 7.6 m. Overall, distance from the tree bole significantly affected the amount of deposition. Deposition was greatest 7.6 m from the tree bole and quickly declined as distance from the tree bole increased. Approximately 97% of total spray deposition occurred within 15.2 m of the tree bole. Application efficiency (i.e., percentage of insecticide applied that is retained on trees) ranged from 80.9 to 87.2%. Based on review of the literature, this amount of drift poses little threat to adjacent aquatic environments. No-spray buffers of 7.6 m should be sufficient to protect freshwater fish, amphibians, crustaceans, bivalves, and most aquatic insects. Buffers >22.9 m appear sufficient to protect the most sensitive aquatic insects (Plecoptera).

Outbreak of Sporotrichosis, Western Australia

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Feeney, Kynan T.; Whittle, Amanda J.; Altman, Shelley A.; Speers, David J.

2007-01-01

A cluster of sporotrichosis cases occurred in the Busselton-Margaret River region of Western Australia from 2000 to 2003. Epidemiologic investigation and mycologic culture for Sporothrix schenckii implicated hay initially distributed through a commercial hay supplier as the source of the outbreak. Declining infection rates have occurred after various community measures were instigated. PMID:17953099

The Study of Campylobacter Frequency in Foodborne Disease Outbreaks in Iran

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Mohammad Mehdi Soltan Dallal

2017-07-01

Full Text Available Introduction:Food-borne diseases are the widespread problems worldwide. Campylobacter species are the most important pathogens causing gastroenteritis which is generally transmitted through the food with animal origin. The aim of this study was to identify the Campylobacter spp. in diarrheal outbreaks in food-borne diseases at country level. Methods:This cross-sectional study carried out in spring and summer, 2015. In total, 305 swabs from diarrheal stool samples of 102 food-borne outbreaks were collected in various provinces of Iran. All samples were examined for the presence and growth of Campylobacter spp. The descriptive analysis, chi-square test and SPSS v.21 software were used for the analysis of results. Results:From the total of 102 foodborne outbreaks, Zanjan Province with 24 outbreaks (24.5% and Yazd Province with 70 samples of diarrhea (23% included the most reported cases. Out of 305 tested samples, 119 (39% were from food, 35 (11.5% from water and 151 (41.5% from unknown sources (p <0.001.  Two outbreaks in Yazd Province including three stool samples contained Campylobacter coli. Typical symptoms included diarrhea (30.9%, abdominal cramps (68.5%, fever (31.8%, headache (42.3%, diarrhea (5.2%, nausea (62.3% and vomiting (64.9%. Conclusion:Results from this study showed that C. coli was responsible for diarrhea rather than C. jejuni.

An international point source outbreak of typhoid fever: a European collaborative investigation*

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Stanwell-Smith, R. E.; Ward, L. R.

1986-01-01

A point source outbreak of Salmonella typhi, degraded Vi-strain 22, affecting 32 British visitors to Kos, Greece, in 1983 was attributed by a case—control study to the consumption of a salad at one hotel. This represents the first major outbreak of typhoid fever in which a salad has been identified as the vehicle. The source of the infection was probably a carrier in the hotel staff. The investigation demonstrates the importance of national surveillance, international cooperation, and epidemiological methods in the investigation and control of major outbreaks of infection. PMID:3488842

An Outbreak of Salmonella Typhimurium infections in Denmark, Norway and Sweden, 2008

DEFF Research Database (Denmark)

Bruun, T; Sørensen, Gitte; Forshell, L P

2009-01-01

countries. In Denmark, a total of 37 cases were identified, and multiple findings of the outbreak strain in pork and pigs within the same supply chain led to the identification of pork in various forms as the source. In Norway, ten cases were identified, and the outbreak investigation quickly indicated meat...... and tracing the source. This outbreak illustrates that good international communication channels, early alerting mechanisms, inter-sectoral collaboration between public health and food safety authorities and harmonised molecular typing tools are important for effective identification and management of cross...

Cholera outbreak in a village in south India – Timely action saved lives

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R. Deepthi

2013-02-01

Full Text Available Summary: Cholera remains a public health concern in developing countries because of its high morbidity and mortality. This study was designed to assess the magnitude of and factors responsible for an outbreak in a South Indian village and to implement measures for containing and preventing the recurrence of such outbreaks. Data was obtained by surveying households in the village to identify cases and assess factors responsible for the outbreak. A sanitary survey of the water supply system was performed to identify the cause of the outbreak. Preventive measures were implemented by setting up a rapid response team to manage cases and provide safe drinking water and health education regarding the prevention of such outbreaks. A total of 73 cases were reported during the outbreak, an attack rate of 17.5%. Attack rates were similar among males and females, and the highest rates were observed among the elderly (33.3%, while the lowest rates were observed among adults (14.7%. There were no deaths reported due to cholera in the village. Most households (81% surveyed did not use any method of water purification, 79.7% practiced open field defecation and 58.2% practiced inadequate hand washing, indicating poor sanitary practices. Cases were most commonly observed in houses which did not practice any method of water purification (p < 0.001 and among people living below the poverty line (p = 0.02. Despite the high attack rate, no deaths were reported, largely thanks to timely medical and preventive interventions. Keywords: Outbreak investigation, Cholera, Sanitary practices, Prevention

Dynamics of a Tularemia Outbreak in a Closely Monitored Free-Roaming Population of Wild House Mice.

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Dobay, Akos; Pilo, Paola; Lindholm, Anna K; Origgi, Francesco; Bagheri, Homayoun C; König, Barbara

2015-01-01

Infectious disease outbreaks can be devastating because of their sudden occurrence, as well as the complexity of monitoring and controlling them. Outbreaks in wildlife are even more challenging to observe and describe, especially when small animals or secretive species are involved. Modeling such infectious disease events is relevant to investigating their dynamics and is critical for decision makers to accomplish outbreak management. Tularemia, caused by the bacterium Francisella tularensis, is a potentially lethal zoonosis. Of the few animal outbreaks that have been reported in the literature, only those affecting zoo animals have been closely monitored. Here, we report the first estimation of the basic reproduction number R0 of an outbreak in wildlife caused by F. tularensis using quantitative modeling based on a susceptible-infected-recovered framework. We applied that model to data collected during an extensive investigation of an outbreak of tularemia caused by F. tularensis subsp. holarctica (also designated as type B) in a closely monitored, free-roaming house mouse (Mus musculus domesticus) population in Switzerland. Based on our model and assumptions, the best estimated basic reproduction number R0 of the current outbreak is 1.33. Our results suggest that tularemia can cause severe outbreaks in small rodents. We also concluded that the outbreak self-exhausted in approximately three months without administrating antibiotics.

Dynamics of a Tularemia Outbreak in a Closely Monitored Free-Roaming Population of Wild House Mice.

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Akos Dobay

Full Text Available Infectious disease outbreaks can be devastating because of their sudden occurrence, as well as the complexity of monitoring and controlling them. Outbreaks in wildlife are even more challenging to observe and describe, especially when small animals or secretive species are involved. Modeling such infectious disease events is relevant to investigating their dynamics and is critical for decision makers to accomplish outbreak management. Tularemia, caused by the bacterium Francisella tularensis, is a potentially lethal zoonosis. Of the few animal outbreaks that have been reported in the literature, only those affecting zoo animals have been closely monitored. Here, we report the first estimation of the basic reproduction number R0 of an outbreak in wildlife caused by F. tularensis using quantitative modeling based on a susceptible-infected-recovered framework. We applied that model to data collected during an extensive investigation of an outbreak of tularemia caused by F. tularensis subsp. holarctica (also designated as type B in a closely monitored, free-roaming house mouse (Mus musculus domesticus population in Switzerland. Based on our model and assumptions, the best estimated basic reproduction number R0 of the current outbreak is 1.33. Our results suggest that tularemia can cause severe outbreaks in small rodents. We also concluded that the outbreak self-exhausted in approximately three months without administrating antibiotics.

2014 outbreak of enterovirus D68 in North America.

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Messacar, Kevin; Abzug, Mark J; Dominguez, Samuel R

2016-05-01

Enterovirus D68 (EV-D68) is an emerging picornavirus which causes severe respiratory disease, predominantly in children. In 2014, the largest and most widespread outbreak of EV-D68 described to date was reported in North America. Hospitals throughout the United States and Canada reported surges in patient volumes and resource utilization from August to October, 2014. In the US a total of 1,153 infections were confirmed in 49 states, although this is an underestimate of the likely millions of cases that occurred but were not tested. EV-D68 was detected in 14 patients who died; the role of the virus in these deaths is unknown. A possible association between EV-D68 and cases of acute flaccid paralysis with spinal cord gray matter lesions, known as acute flaccid myelitis, was observed during the outbreak and is under investigation. The 2014 outbreak of EV-D68 in North America demonstrates the public health importance of this emerging pathogen. © 2015 Wiley Periodicals, Inc.

Fish and Shellfish Associated Disease Outbreaks.

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Levin, M.

1978-01-01

Presents a literature review of disease outbreaks related to fish and shellfish, covering publications of 1976-77. This review covers the chemical, bacterial, and viral diseases that are transmitted by fish and shellfish. A list of 50 references is also presented. (HM)

Tornado outbreak variability follows Taylor's power law of fluctuation scaling and increases dramatically with severity.

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Tippett, Michael K; Cohen, Joel E

2016-02-29

Tornadoes cause loss of life and damage to property each year in the United States and around the world. The largest impacts come from 'outbreaks' consisting of multiple tornadoes closely spaced in time. Here we find an upward trend in the annual mean number of tornadoes per US tornado outbreak for the period 1954-2014. Moreover, the variance of this quantity is increasing more than four times as fast as the mean. The mean and variance of the number of tornadoes per outbreak vary according to Taylor's power law of fluctuation scaling (TL), with parameters that are consistent with multiplicative growth. Tornado-related atmospheric proxies show similar power-law scaling and multiplicative growth. Path-length-integrated tornado outbreak intensity also follows TL, but with parameters consistent with sampling variability. The observed TL power-law scaling of outbreak severity means that extreme outbreaks are more frequent than would be expected if mean and variance were independent or linearly related.

Tornado outbreak variability follows Taylor's power law of fluctuation scaling and increases dramatically with severity

Science.gov (United States)

Tippett, Michael K.; Cohen, Joel E.

2016-01-01

Tornadoes cause loss of life and damage to property each year in the United States and around the world. The largest impacts come from ‘outbreaks' consisting of multiple tornadoes closely spaced in time. Here we find an upward trend in the annual mean number of tornadoes per US tornado outbreak for the period 1954–2014. Moreover, the variance of this quantity is increasing more than four times as fast as the mean. The mean and variance of the number of tornadoes per outbreak vary according to Taylor's power law of fluctuation scaling (TL), with parameters that are consistent with multiplicative growth. Tornado-related atmospheric proxies show similar power-law scaling and multiplicative growth. Path-length-integrated tornado outbreak intensity also follows TL, but with parameters consistent with sampling variability. The observed TL power-law scaling of outbreak severity means that extreme outbreaks are more frequent than would be expected if mean and variance were independent or linearly related. PMID:26923210

Tularemia Outbreaks and Common Vole (Microtus arvalis) Irruptive Population Dynamics in Northwestern Spain, 1997-2014.

Science.gov (United States)

Luque-Larena, Juan José; Mougeot, François; Roig, Dolors Vidal; Lambin, Xavier; Rodríguez-Pastor, Ruth; Rodríguez-Valín, Elena; Anda, Pedro; Escudero, Raquel

2015-09-01

During the last decades, large tularemia outbreaks in humans have coincided in time and space with population outbreaks of common voles in northwestern Spain, leading us to hypothesize that this rodent species acts as a key spillover agent of Francisella tularensis in the region. Here, we evaluate for the first time a potential link between irruptive vole numbers and human tularemia outbreaks in Spain. We compiled vole abundance estimates obtained through live-trapping monitoring studies and official reports of human tularemia cases during the period 1997-2014. We confirm a significant positive association between yearly cases of tularemia infection in humans and vole abundance. High vole densities during outbreaks (up to 1000 voles/hectare) may therefore enhance disease transmission and spillover contamination in the environment. If this ecological link is further confirmed, the apparent multiannual cyclicity of common vole outbreaks might provide a basis for forecasting the risk of tularemia outbreaks in northwestern Spain.

[Practical lessons from the risk management of an outbreak of acute gastroenteritis in a public school].

Science.gov (United States)

Morillo-García, Aurea; Sillero-Sánchez, Rocío; Aldana-Espinal, Josefa María; Nieto-Cervera, Pilar

2005-01-01

We present our reflections on the management of an acute gastroenteritis outbreak in a public school, which caused a public health crisis, and the conclusions drawn from this experience. The methodology of strengths, weaknesses, opportunities, and threats (SWOT) analysis was used. This article describes the epidemiology of the incident and the policy decisions made, but focuses on operational aspects of outbreak management. The experience of the outbreak control team, liaison with other organizations, and data management are discussed. The difficulties encountered by the outbreak team related to delay in declaring in the outbreak, lack of training in some of the entities involved, and incorrect use of the surveillance circuits. Current protocols and specific action plans for the management of outbreaks should be improved through self-evaluation and updating of resources and knowledge.

Larval outbreaks in West Greenland

DEFF Research Database (Denmark)

Lund, Magnus; Raundrup, Katrine; Westergaard-Nielsen, Andreas

2017-01-01

effects of a larval outbreak in 2011 on vegetation productivity and CO2 exchange. We estimate a decreased carbon (C) sink strength in the order of 118–143 g C m−2, corresponding to 1210–1470 tonnes C at the Kobbefjord catchment scale. The decreased C sink was, however, counteracted the following years...

Early decision indicators for foot-and-mouth disease outbreaks in non-endemic countries

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Michael Graeme Garner

2016-11-01

Full Text Available Disease managers face many challenges when deciding on the most effective control strategy to manage an outbreak of foot and mouth disease (FMD. Decisions have to be made under conditions of uncertainty and where the situation is continually evolving. In addition, resources for control are often limited. A modelling study was carried out to identify characteristics measurable during the early phase of a FMD outbreak that might be useful as predictors of the total number of infected places, outbreak duration and the total area under control. The study involved two modelling platforms in two countries (Australia and New Zealand and encompassed a large number of incursion scenarios. Linear regression, classification and regression tree and boosted regression tree analyses were used to quantify the predictive value of a set of parameters on three outcome variables of interest: the total number of infected places, outbreak duration and the total area under control. The number of infected premises, number of pending culls, area under control, estimated dissemination ratio, and cattle density around the index herd at days 7, 14 and 21 following first detection were associated with each of the outcome variables. Regression models for the size of the area under control had the highest predictive value (R2 = 0.51-0.9 followed by the number of infected premises (R2 = 0.3-0.75 and outbreak duration (R2 = 0.28-0.57. Predictability improved at later time points in the outbreak. Predictive regression models using various cut-points at day 14 to define small and large outbreaks had positive predictive values of 0.85‒0.98 and negative predictive values of 0.52‒0.91, with 79‒97% of outbreaks correctly classified. On the strict assumption that each of the simulation models used in this study provide a realistic indication of the spread of FMD in animal populations our conclusion is that relatively simple metrics available early in a control program can be

A Short Overview of Ebola Outbreak

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Masumeh Saeidi

2014-10-01

Full Text Available   Ebola virus disease (formerly known as Ebola haemorrhagic fever is a severe, often fatal illness, with a death rate of up to 90%. The illness affects humans and nonhuman primates (monkeys, gorillas, and chimpanzees. Ebola first appeared in 1976 in two simultaneous outbreaks, one in a village near the Ebola River in the Democratic Republic of Congo, and the other in a remote area of Sudan. The origin of the virus is unknown but fruit bats (Pteropodidae are considered the likely host of the Ebola virus, based on available evidence. In the current outbreak in West Africa, the majority of cases in humans have occurred as a result of human-to-human transmission. Infection occurs from direct contact through broken skin or mucous membranes with the blood, or other bodily fluids or secretions (stool, urine, saliva, semen of infected people.

Enviromnental contamination during a vancomycin-resistant Enterococci outbreak at a hospital in Argentina

OpenAIRE

Zarate, Mariela Soledad; Gales, Ana [UNIFESP; Jordd-Vargas, L'fiana; Yahni, Diego; RelloSo, Silvia; Bonvehi, Pablo; Monteiro, Jussimara [UNIFESP; Campos-Pignatari, Antonio [UNIFESP; Smayevsky, Jorgelina [UNIFESP

2007-01-01

INTRODUCTION. Vancomycin-resistant enterococci isolates (VRE) have caused numerous outbreaks in intensive care units (ICUs). A contaminated hospital environment, the hands of health care workers (HCW), and carrier patients may play important roles in perpetuating the chain of transmission in these outbreaks. the aims of this study were to report the first VRE outbreak in our center and assess the role of environmental contamination and HCW hands in the spread of new cases of enterococcal infe...

Clostridium perfringens in London, July 2009: two weddings and an outbreak.

Science.gov (United States)

Eriksen, J; Zenner, D; Anderson, S R; Grant, K; Kumar, D

2010-06-24

Food poisoning outbreaks caused by Clostridium perfringens enterotoxin occur occasionally in Europe but have become less common in recent years. This paper presents the microbiological and epidemiological results of a large C. perfringens outbreak occurring simultaneously at two weddings that used the same caterer. The outbreak involved several London locations and required coordination across multiple agencies. A case-control study (n=134) was carried out to analyse possible associations between the food consumed and becoming ill. Food, environmental and stool samples were tested for common causative agents, including enterotoxigenic C. perfringens. The clinical presentation and the epidemiological findings were compatible with C. perfringens food poisoning and C. perfringens enterotoxin was detected in stool samples from two cases. The case-control study found statistically significant associations between becoming ill and eating either a specific chicken or lamb dish prepared by the same food handler of the implicated catering company. A rapid outbreak investigation with preliminary real-time results and the successful collaboration between the agencies and the caterer led to timely identification and rectification of the failures in the food handling practices.

An assessment of the geographical risks of wild and vaccine-derived poliomyelitis outbreaks in Africa and Asia.

Science.gov (United States)

O'Reilly, Kathleen M; Lamoureux, Christine; Molodecky, Natalie A; Lyons, Hil; Grassly, Nicholas C; Tallis, Graham

2017-05-26

The international spread of wild poliomyelitis outbreaks continues to threaten eradication of poliomyelitis and in 2014 a public health emergency of international concern was declared. Here we describe a risk scoring system that has been used to assess country-level risks of wild poliomyelitis outbreaks, to inform prioritisation of mass vaccination planning, and describe the change in risk from 2014 to 2016. The methods were also used to assess the risk of emergence of vaccine-derived poliomyelitis outbreaks. Potential explanatory variables were tested against the reported outbreaks of wild poliomyelitis since 2003 using multivariable regression analysis. The regression analysis was translated to a risk score and used to classify countries as Low, Medium, Medium High and High risk, based on the predictive ability of the score. Indicators of population immunity, population displacement and diarrhoeal disease were associated with an increased risk of both wild and vaccine-derived outbreaks. High migration from countries with wild cases was associated with wild outbreaks. High birth numbers were associated with an increased risk of vaccine-derived outbreaks. Use of the scoring system is a transparent and rapid approach to assess country risk of wild and vaccine-derived poliomyelitis outbreaks. Since 2008 there has been a steep reduction in the number of wild poliomyelitis outbreaks and the reduction in countries classified as High and Medium High risk has reflected this. The risk of vaccine-derived poliomyelitis outbreaks has varied geographically. These findings highlight that many countries remain susceptible to poliomyelitis outbreaks and maintenance or improvement in routine immunisation is vital.

The 2011 outbreak of African horse sickness in the African horse sickness controlled area in South Africa

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John D. Grewar

2013-11-01

Full Text Available African horse sickness (AHS is a controlled animal disease in South Africa, and as a result of the high mortality rates experienced, outbreaks in the AHS controlled area in the Western Cape Province have a significant impact on affected properties as well as on the exportation of live horses from the AHS free zone in metropolitan Cape Town. An outbreak of AHS serotype 1 occurred in the surveillance zone of the AHS controlled area of the Western Cape during the summer of 2011. The epicentre of the outbreak was the town of Mamre in the magisterial district of Malmesbury and the outbreak was confined to a defined containment zone within this area by movement control of all equids and a blanket vaccination campaign. A total of 73 cases of AHS were confirmed during this outbreak, which included four confirmed subclinical cases. The morbidity rate for the outbreak was 16%with a mortality rate of 14%and a case fatality rate of 88%. Outbreak disease surveillance relied on agent identification using polymerase chain reaction (PCR-based assays, which is novel for an AHS outbreak in South Africa. The source of this outbreak was never confirmed although it is believed to be associated with the illegal movement of an infected animal into the Mamre area. This detailed description of the outbreak provides a sound scientific basis to assist decision making in future AHS outbreaks in the AHS controlled area of South Africa and in countries where AHS is an exotic or emerging disease.

Family Outbreaks of Nontyphoidal Salmonellosis following a Meal of Guinea Pigs.

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Fournier, John B; Knox, Kimberly; Harris, Maureen; Newstein, Michael

2015-01-01

Salmonella outbreaks have been linked to a wide variety of foods, including recent nationwide outbreaks. Guinea pig (Cavia porcellus), also known as cuy or cobayo, has long been a popular delicacy and ceremonial food in the Andean region in South America. This case report describes three family outbreaks of nontyphoidal salmonellosis, each occurring after a meal of guinea pigs. We believe this case report is the first to describe a probable association between the consumption of guinea pig meat and human salmonellosis. Physicians should be aware of the association of Salmonella and the consumption of guinea pigs, given the increasing immigration of people from the Andean region of South America and the increasing travel to this region.

Using typing techniques in a specific outbreak: the ethical reflection of public health professionals.

Science.gov (United States)

Rump, B; Cornelis, C; Woonink, F; VAN Steenbergen, J; Verweij, M; Hulscher, M

2017-05-01

Typing techniques are laboratory methods used in outbreak management to investigate the degree to which microbes found within an outbreak are related. Knowledge about relational patterns between microbes benefits outbreak management, but inevitably also tells us something about the relational patterns of the people hosting them. Since the technique is often used without explicit consent of all individuals involved, this may raise ethical questions. The aim of this study was to unravel the complex ethical deliberation of professionals over the use of such techniques. We organised group discussions (n = 3) with Dutch outbreak managers (n = 23). The topic list was based on previously identified ethical issues and discussions were analysed for recurrent themes. We found that outbreak managers first and foremost reflect on the balance of individual harm with public health benefit. This key question was approached by way of discussing four more specific ethical themes: (1) justification of governmental intervention, (2) responsibility to prevent infections, (3) scientific uncertainty and (4) legal consequences. The themes found in this study, rephrased into accessible questions, represent the shared ethical understanding of professionals and can help to articulate the ethical dimensions of using molecular science in response to infectious disease outbreaks.

Mycobacterium massiliense outbreak after intramuscular injection, South Korea.

Science.gov (United States)

Kim, H J; Cho, Y; Lee, S; Kook, Y; Lee, D; Lee, J; Park, B J

2012-10-01

SUMMARY We conducted an epidemic investigation to discover the route of transmission and the host factors of an outbreak of post-injection abscesses. Of the 2984 patients who visited a single clinic, 77 cases were identified and 208 age- and sex-matched controls were selected for analysis. Injected medications per se were not found to be responsible, and a deviation from safe injection practice suggested the likelihood of diluent contamination. Therefore the injected medications were classified according to whether there was a need for a diluent, and two medications showed a statistically significant association, i.e. injection with pheniramine [adjusted odds ratios (aOR) 5·93, 95% confidence interval (CI) 2·97-11·87] and ribostamycin (aOR 47·95, 95% CI 11·08-207·53). However, when considered concurrently, pheniramine lost statistical significance (aOR 8·71, 95% CI 0·44-171·61) suggesting that normal saline was the causative agent of this outbreak. Epidemiological evidence strongly suggested that this post-injection outbreak was caused by saline contaminated with Mycobacterium massiliense without direct microbiological evidence.

Spatio-temporal epidemiology of the cholera outbreak in Papua New Guinea, 2009-2011.

Science.gov (United States)

Horwood, Paul F; Karl, Stephan; Mueller, Ivo; Jonduo, Marinjho H; Pavlin, Boris I; Dagina, Rosheila; Ropa, Berry; Bieb, Sibauk; Rosewell, Alexander; Umezaki, Masahiro; Siba, Peter M; Greenhill, Andrew R

2014-08-20

Cholera continues to be a devastating disease in many developing countries where inadequate safe water supply and poor sanitation facilitate spread. From July 2009 until late 2011 Papua New Guinea experienced the first outbreak of cholera recorded in the country, resulting in >15,500 cases and >500 deaths. Using the national cholera database, we analysed the spatio-temporal distribution and clustering of the Papua New Guinea cholera outbreak. The Kulldorff space-time permutation scan statistic, contained in the software package SatScan v9.2 was used to describe the first 8 weeks of the outbreak in Morobe Province before cholera cases spread throughout other regions of the country. Data were aggregated at the provincial level to describe the spread of the disease to other affected provinces. Spatio-temporal and cluster analyses revealed that the outbreak was characterized by three distinct phases punctuated by explosive propagation of cases when the outbreak spread to a new region. The lack of road networks across most of Papua New Guinea is likely to have had a major influence on the slow spread of the disease during this outbreak. Identification of high risk areas and the likely mode of spread can guide government health authorities to formulate public health strategies to mitigate the spread of the disease through education campaigns, vaccination, increased surveillance in targeted areas and interventions to improve water, sanitation and hygiene.

Factors associated with repeated outbreak of anthrax in Bangladesh: qualitative and quantitative study

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Jayedul Hassan

2015-06-01

Full Text Available Anthrax, caused by Bacillus anthracis is an acute, febrile disease of warm blooded animals including humans. Social norms and poverty in addition to climatic factors such as soil conditions, seasons of year, ambient temperature and rainfall influence the persistence of the B. anthracis and anthrax outbreaks. The present study was designed to reveal the factors influencing the repeated outbreak of anthrax in Bangladesh. Considering the previous outbreaks of anthrax, Sirajganj, Bogra, Kushtia, Tangail and Mymensingh districts of Bangladesh were selected for this study. To elucidate the factors, qualitative data relating to the animal management, knowledge and behavior of the people; and quantitative data relating to soil conditions, ambient temperature and rainfall were acquired, and analyzed critically. Based on the outbreak histories, a year was divided into two seasons, anthrax prone season (May-November and anthrax dry season (December-April. Anthrax spores could be isolated from 11.67% (n=14/120 of the soil samples collected from the study areas. The present study revealed that poor knowledge, lack of awareness, improper carcass disposal, inadequate vaccination, high Ca content and moisture in the soil along with high ambient temperature and rainfall during the anthrax prone season were the possible influencing factors of repeated outbreaks of anthrax in the study areas. Intensive propaganda to create public awareness of anthrax together with proper vaccination may reduce anthrax outbreaks in Bangladesh.

Lessons in Outbreak a Consumer perspective

NARCIS (Netherlands)

Fischer, A.R.H.

2008-01-01

Lessons in Outbreak a Consumer perspective. Arnout Fischer Consumer risk perceptions is not necessarily the same as an economic weighing of risks and benefits. Consumers tend to be risk averse, tend to estimate catastrophic, unnatural or involuntary risks as larger, while personal lifestyle risks

The national web-based outbreak rapid alert system in Norway: eight years of experience, 2006-2013.

Science.gov (United States)

Guzman-Herrador, B; Vold, L; Berg, T; Berglund, T M; Heier, B; Kapperud, G; Lange, H; Nygård, K

2016-01-01

In 2005, the Norwegian Institute of Public Health established a web-based outbreak rapid alert system called Vesuv. The system is used for mandatory outbreak alerts from municipal medical officers, healthcare institutions, and food safety authorities. As of 2013, 1426 outbreaks have been reported, involving 32913 cases. More than half of the outbreaks occurred in healthcare institutions (759 outbreaks, 53·2%). A total of 474 (33·2%) outbreaks were associated with food or drinking water. The web-based rapid alert system has proved to be a helpful tool by enhancing reporting and enabling rapid and efficient information sharing between different authorities at both the local and national levels. It is also an important tool for event-based reporting, as required by the International Health Regulations (IHR) 2005. Collecting information from all the outbreak alerts and reports in a national database is also useful for analysing trends, such as occurrence of certain microorganisms, places or sources of infection, or route of transmission. This can facilitate the identification of specific areas where more general preventive measures are needed.

Detection, quantification and genotyping of noroviruses in oysters implicated in disease outbreaks

DEFF Research Database (Denmark)

Haefeli, Deborah; Gantenbein-Demarchi, Corinne; Böttiger, Blenda

2012-01-01

. While GI and GII have often been verified as causative agents of oyster-transmitted illness, GIV is rarely detected and has so far not been confirmed in outbreaks related to oysters. The aim of this study was to determine whether NoVs from oysters implicated in a disease outbreak were linked to the GI......Noroviruses (NoVs) are a major cause of foodborne outbreaks of acute gastroenteritis in humans. Transmission of NoV is commonly linked to the consumption of oysters as they accumulate viruses through filter feeding in faecal-contaminated water. The NoV genogroups (G)I, GII and GIV infect humans...

Outbreaks of Invasive Kingella kingae Infections in Closed Communities.

Science.gov (United States)

Yagupsky, Pablo; Ben-Ami, Yael; Trefler, Ronit; Porat, Nurith

2016-02-01

To describe the results of the epidemiologic investigation of outbreaks of invasive Kingella kingae infections among attendees at daycare facilities located in 4 closed communities in Israel. The preschool-aged population of communities with clusters of Kingella cases had oropharyngeal cultures performed. K kingae isolates from infected patients and healthy contacts were genotyped by pulsed field gel electrophoresis to determine the spread of outbreak strains. The affected closed communities (3 military bases and 1 "kibbutz" commune) were characterized by tight social and family networks and intensive mingling. The outbreaks affected 9 of 51 attendees (attack rate: 17.6%) age 8-19 months (median: 12 months), within a 21-day period. Cases included skeletal system infections (n = 8) and bacteremia (n = 1); K kingae isolates were confirmed by the use of blood culture vials and selective media. Clinical presentation was mild and acute-phase reactants were usually normal or only moderately elevated. Thirty out of 55 (54.5%) asymptomatic children carried the outbreak strains. Analysis of the 3 clusters in which the entire preschool-aged population was cultured revealed that 31 of 71 (43.7%) children younger than 24 months of age were colonized with K kingae organisms compared with 8 of 105 (7.6%) older children (P presentation of invasive K kingae infections and the fastidious nature of the organism, a high index of suspicion and use of sensitive detection methods are recommended. Copyright © 2016 Elsevier Inc. All rights reserved.

More tornadoes in the most extreme U.S. tornado outbreaks.

Science.gov (United States)

Tippett, Michael K; Lepore, Chiara; Cohen, Joel E

2016-12-16

Tornadoes and severe thunderstorms kill people and damage property every year. Estimated U.S. insured losses due to severe thunderstorms in the first half of 2016 were $8.5 billion (US). The largest U.S. effects of tornadoes result from tornado outbreaks, which are sequences of tornadoes that occur in close succession. Here, using extreme value analysis, we find that the frequency of U.S. outbreaks with many tornadoes is increasing and that it is increasing faster for more extreme outbreaks. We model this behavior by extreme value distributions with parameters that are linear functions of time or of some indicators of multidecadal climatic variability. Extreme meteorological environments associated with severe thunderstorms show consistent upward trends, but the trends do not resemble those currently expected to result from global warming. Copyright © 2016, American Association for the Advancement of Science.

Food poisoning outbreak in a training establishment: A retrospective cohort study

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Maramraj Kiran Kumar

2017-01-01

Full Text Available Background: An outbreak of food poisoning occurred among recruits in a training establishment. Investigation of outbreak was undertaken with active preventive interventions concurrently to arrest the current outbreak as well as to avoid such incidents in future. Materials and Methods: A retrospective cohort study was undertaken among all recruits, regardless of presence or absence of symptoms. The risk ratios (relative risks and attributable risks were calculated for each food item of the suspected meal to assess the association between consumption of individual food items and subsequent illness. An environmental survey was undertaken to investigate into the course of food processing and storage facilities at trainees' galley (cookhouse and other relevant eating establishments. Results: A total of 494 recruits reported with symptoms of gastroenteritis in a span of 3 days. Of those affected, only 9 were admitted and rest recovered with treatment on OPD basis. The overall attack rate was 22.9%. No deaths were reported. It was a classical point source, single exposure gastroenteritis outbreak. When food histories and sickness histories were analyzed, the attributable risk (24.17 and relative risk (5.11 were highest for the “Flavoured milk,” which was an outsourced item. The statistical findings were substantiated with environmental and epidemiological evidence. Conclusion: Epidemiological investigation incriminated dinner of the previous day as the meal responsible for the outbreak with flavored milk as the most attributable food item.

Climate Teleconnections and Recent Patterns of Human and Animal Disease Outbreaks

Science.gov (United States)

Anyamba, Assaf; Linthicum, Kenneth J.; Small, Jennifer L.; Collins, Katherine M.; Tucker, Compton J.; Pak, Edwin W.; Britch, Seth C.; Eastman, James Ronald; Pinzon, Jorge E.; Russell, Kevin L.

2011-01-01

Recent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya) in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Extremes in rainfall (drought and flood) during the period 2004 - 2009 have privileged different disease vectors. Chikungunya outbreaks occurred during the severe drought from late 2004 to 2006 over coastal East Africa and the western Indian Ocean islands and in the later years India and Southeast Asia. The chikungunya pandemic was caused by a Central/East African genotype that appears to have been precipitated and then enhanced by global-scale and regional climate conditions in these regions. Outbreaks of Rift Valley fever occurred following excessive rainfall period from late 2006 to late 2007 in East Africa and Sudan, and then in 2008 - 2009 in Southern Africa. The shift in the outbreak patterns of Rift Valley fever from East Africa to Southern Africa followed a transition of the El Nino/Southern Oscillation (ENSO) phenomena from the warm El Nino phase (2006-2007) to the cold La Nina phase (2007-2009) and associated patterns of variability in the greater Indian Ocean basin that result in the displacement of the centres of above normal rainfall from Eastern to Southern Africa. Understanding the background patterns of climate variability both at global and regional scale and their impacts on ecological drivers of vector borne-diseases is critical in long-range planning of appropriate response and mitigation measures.

Listeriosis Outbreaks in British Columbia, Canada, Caused by Soft Ripened Cheese Contaminated from Environmental Sources

Science.gov (United States)

Wilcott, Lynn; Naus, Monika

2015-01-01

Soft ripened cheese (SRC) caused over 130 foodborne illnesses in British Columbia (BC), Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m.), an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant's water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant's open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence. PMID:25918702

Listeriosis Outbreaks in British Columbia, Canada, Caused by Soft Ripened Cheese Contaminated from Environmental Sources

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Lorraine McIntyre

2015-01-01

Full Text Available Soft ripened cheese (SRC caused over 130 foodborne illnesses in British Columbia (BC, Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m., an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant’s water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant’s open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence.

Epidemiology of Foot and Mouth Disease in Ethiopia: a Retrospective Analysis of District Level Outbreaks, 2007-2012.

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Jemberu, W T; Mourits, M C M; Sahle, M; Siraw, B; Vernooij, J C M; Hogeveen, H

2016-12-01

This study aimed at determining the incidence, distribution, risk factors, and causal serotypes of foot and mouth disease (FMD) outbreaks in Ethiopia based on 5 years of retrospective outbreak data (September 2007 until August 2012). District level outbreak data were collected from 115 randomly selected districts using a questionnaire administered to district animal health officers. The national incidence of FMD outbreaks during the study period was 1.45 outbreaks per five district years. Outbreaks were geographically widespread affecting all major regional states in the country and were more frequent in the central, southern, and southeastern parts of the country. Neither long-term nor seasonal trends were observed in the incidence of outbreaks. A mixed effects logistic regression analysis revealed that the type of production system (market oriented system versus subsistence systems), presence of a major livestock market and/or route, and adjacency to a national parks or wildlife sanctuary were found to be associated with increased risk of outbreaks in the districts. FMD virus serotypes O, A, SAT 2, and SAT 1 were identified as the causal serotypes of the outbreaks during the study period. Whereas O was the dominant serotype, SAT 2 was the serotype that showed increase in relative frequency of occurrence. The estimated incidence of outbreaks is useful in assessing the economic impacts of the disease, and the identified risk factors provide important knowledge to target a progressive FMD control policy for Ethiopia. © 2015 Blackwell Verlag GmbH.

Outbreak!: Teaching Clinical and Diagnostic Microbiology Methodologies with an Interactive Online Game

Science.gov (United States)

Clark, Sherri; Smith, Geoffrey Battle

2004-01-01

Outbreak! is an online, interactive educational game that helps students and teachers learn and evaluate clinical microbiology skills. When the game was used in introductory microbiology laboratories, qualitative evaluation by students showed very positive responses and increased learning. Outbreak! allows students to design diagnostic tests and…

Preparing for a Pandemic Flu Outbreak

Science.gov (United States)

Dittbenner, Richard

2009-01-01

This article discusses the things college leaders should know and do in case of a pandemic influenza outbreak. The author talks about four principles that will guide college leaders in developing a pandemic influenza plan and presents the 10 elements of an effective college pandemic planning process.

Tactics and Strategies for Managing Ebola Outbreaks and the Salience of Immunization

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Wayne M. Getz

2015-01-01

Full Text Available We present a stochastic transmission chain simulation model for Ebola viral disease (EVD in West Africa, with the salutary result that the virus may be more controllable than previously suspected. The ongoing tactics to detect cases as rapidly as possible and isolate individuals as safely as practicable is essential to saving lives in the current outbreaks in Guinea, Liberia, and Sierra Leone. Equally important are educational campaigns that reduce contact rates between susceptible and infectious individuals in the community once an outbreak occurs. However, due to the relatively low R0 of Ebola (around 1.5 to 2.5 next generation cases are produced per current generation case in naïve populations, rapid isolation of infectious individuals proves to be highly efficacious in containing outbreaks in new areas, while vaccination programs, even with low efficacy vaccines, can be decisive in curbing future outbreaks in areas where the Ebola virus is maintained in reservoir populations.

Tactics and strategies for managing Ebola outbreaks and the salience of immunization.

Science.gov (United States)

Getz, Wayne M; Gonzalez, Jean-Paul; Salter, Richard; Bangura, James; Carlson, Colin; Coomber, Moinya; Dougherty, Eric; Kargbo, David; Wolfe, Nathan D; Wauquier, Nadia

2015-01-01

We present a stochastic transmission chain simulation model for Ebola viral disease (EVD) in West Africa, with the salutary result that the virus may be more controllable than previously suspected. The ongoing tactics to detect cases as rapidly as possible and isolate individuals as safely as practicable is essential to saving lives in the current outbreaks in Guinea, Liberia, and Sierra Leone. Equally important are educational campaigns that reduce contact rates between susceptible and infectious individuals in the community once an outbreak occurs. However, due to the relatively low R 0 of Ebola (around 1.5 to 2.5 next generation cases are produced per current generation case in naïve populations), rapid isolation of infectious individuals proves to be highly efficacious in containing outbreaks in new areas, while vaccination programs, even with low efficacy vaccines, can be decisive in curbing future outbreaks in areas where the Ebola virus is maintained in reservoir populations.

Tail posture predicts tail biting outbreaks at pen level in weaner pigs

DEFF Research Database (Denmark)

Lahrmann, Helle Pelant; Hansen, Christian Fink; D'Eath, Rick

2018-01-01

posture and behaviour could be detected at pen level between upcoming tail biting pens (T-pens) and control pens (C-pens). The study included 2301 undocked weaner pigs in 74 pens (mean 31.1 pigs/pen; SD 1.5). Tails were scored three times weekly (wound freshness, wound severity and tail length) between 07......Detecting a tail biting outbreak early is essential to reduce the risk of pigs getting severe tail damage. A few previous studies suggest that tail posture and behavioural differences can predict an upcoming outbreak. The aim of the present study was therefore to investigate if differences in tail......:00 h-14:00 h from weaning until a tail biting outbreak. An outbreak (day 0) occurred when at least four pigs had a tail damage, regardless of wound freshness. On average 7.6 (SD 4.3) pigs had a damaged tail (scratches + wound) in T-pens on day 0. Tail posture and behaviour (activity, eating...

Outbreaks of infections associated with drug diversion by US health care personnel.

Science.gov (United States)

Schaefer, Melissa K; Perz, Joseph F

2014-07-01

To summarize available information about outbreaks of infections stemming from drug diversion in US health care settings and describe recommended protocols and public health actions. We reviewed records at the Centers for Disease Control and Prevention related to outbreaks of infections from drug diversion by health care personnel in US health care settings from January 1, 2000, through December 31, 2013. Searches of the medical literature published during the same period were also conducted using PubMed. Information compiled included health care setting(s), infection type(s), specialty of the implicated health care professional, implicated medication(s), mechanism(s) of diversion, number of infected patients, number of patients with potential exposure to blood-borne pathogens, and resolution of the investigation. We identified 6 outbreaks over a 10-year period beginning in 2004; all occurred in hospital settings. Implicated health care professionals included 3 technicians and 3 nurses, one of whom was a nurse anesthetist. The mechanism by which infections were spread was tampering with injectable controlled substances. Two outbreaks involved tampering with opioids administered via patient-controlled analgesia pumps and resulted in gram-negative bacteremia in 34 patients. The remaining 4 outbreaks involved tampering with syringes or vials containing fentanyl; hepatitis C virus infection was transmitted to 84 patients. In each of these outbreaks, the implicated health care professional was infected with hepatitis C virus and served as the source; nearly 30,000 patients were potentially exposed to blood-borne pathogens and targeted for notification advising testing. These outbreaks revealed gaps in prevention, detection, and response to drug diversion in US health care facilities. Drug diversion is best prevented by health care facilities having strong narcotics security measures and active monitoring systems. Appropriate response includes assessment of harm to

Assessing the environmental health relevance of cooling towers--a systematic review of legionellosis outbreaks.

Science.gov (United States)

Walser, Sandra M; Gerstner, Doris G; Brenner, Bernhard; Höller, Christiane; Liebl, Bernhard; Herr, Caroline E W

2014-03-01

Bioaerosols from cooling towers are often suspected to cause community-acquired legionellosis outbreaks. Although Legionella infections can mostly be assigned to the emission sources, uncertainty exists about the release and distribution into the air, the occurrence of the respirable virulent form and the level of the infective concentration. Our study aimed to evaluate studies on legionellosis outbreaks attributed to cooling towers published within the last 11 years by means of a systematic review of the literature. 19 legionellosis outbreaks were identified affecting 12 countries. Recurring events were observed in Spain and Great Britain. In total, 1609 confirmed cases of legionellosis and a case-fatality rate of approximately 6% were reported. Duration of outbreaks was 65 days on average. For diagnosis the urinary antigen test was mainly used. Age, smoking, male sex and underlying diseases (diabetes, immunodeficiency) could be confirmed as risk factors. Smoking and underlying diseases were the most frequent risk factors associated with legionellosis in 11 and 10 of the 19 studies, respectively. The meteorological conditions varied strongly. Several studies reported a temporal association of outbreaks with inadequate maintenance of the cooling systems. A match of clinical and environmental isolates by serotyping and/or molecular subtyping could be confirmed in 84% of outbreaks. Legionella-contaminated cooling towers as environmental trigger, in particular in the neighbourhood of susceptible individuals, can cause severe health problems and even death. To prevent and control Legionella contamination of cooling towers, maintenance actions should focus on low-emission cleaning procedures of cooling towers combined with control measurements of water and air samples. Procedures allowing rapid detection and risk assessment in the case of outbreaks are essential for adequate public health measures. Systematic registration of cooling towers will facilitate the

Severe Dengue Fever Outbreak in Taiwan.

Science.gov (United States)

Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

2016-01-01

Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005-2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. © The American Society of Tropical Medicine and Hygiene.

Nosocomial outbreak of cryptosporidiosis in AIDS patients

DEFF Research Database (Denmark)

Ravn, Pernille; Lundgren, Jens Dilling; Kjaeldgaard, P

1991-01-01

OBJECTIVE--To describe a nosocomial outbreak of cryptosporidiosis during four months after June 1989. SETTING--A department of infectious diseases in Copenhagen, seeing about half the patients with AIDS in Denmark. SUBJECTS--73 HIV antibody negative subjects and 60 antibody positive subjects...... admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis. MAIN OUTCOME...... out ice for cold drinks. The mean incubation time was at least 13 days-that is, twice that in HIV-negative patients. Of the 18 patients with AIDS who developed cryptosporidiosis, five recovered, two were symptomless carriers, three died of unrelated causes, and eight died after prolonged diarrhoea...

A large outbreak of shigellosis commencing in an internally displaced population, Papua New Guinea, 2013.

Science.gov (United States)

Benny, Edwin; Mesere, Kelly; Pavlin, Boris I; Yakam, Logan; Ford, Rebecca; Yoannes, Mition; Kisa, Debbie; Abdad, Mohammad Y; Menda, Lincoln; Greenhill, Andrew R; Horwood, Paul F

2014-01-01

The objective of this study was to investigate a large outbreak of shigellosis in Papua New Guinea that began in a camp for internally displaced persons before spreading throughout the general community. Outbreak mitigation strategies were implemented in the affected area to curtail the spread of the disease. Data were collected from the surveillance system and analysed by time, place and person. Rectal swab samples were tested by standard culture methods and real-time polymerase chain reaction to determine the etiology of the outbreak. Laboratory analysis at two independent institutions established that the outbreak was caused by Shigella sp., with one strain further characterized as Shigella flexneri serotype 2. Approximately 1200 suspected cases of shigellosis were reported in a two-month period from two townships in Morobe Province, Papua New Guinea. The outbreak resulted in at least five deaths, all in young children. This outbreak of shigellosis highlights the threat of enteric diseases to vulnerable populations such as internally displaced persons in Papua New Guinea, as has been observed in other global settings.

A large outbreak of shigellosis commencing in an internally displaced population, Papua New Guinea, 2013

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Edwin Benny

2014-09-01

Full Text Available Objective: The objective of this study was to investigate a large outbreak of shigellosis in Papua New Guinea that began in a camp for internally displaced persons before spreading throughout the general community. Methods: Outbreak mitigation strategies were implemented in the affected area to curtail the spread of the disease. Data were collected from the surveillance system and analysed by time, place and person. Rectal swab samples were tested by standard culture methods and real-time polymerase chain reaction to determine the etiology of the outbreak. Results: Laboratory analysis at two independent institutions established that the outbreak was caused by Shigella sp., with one strain further characterized as Shigella flexneri serotype 2. Approximately 1200 suspected cases of shigellosis were reported in a two-month period from two townships in Morobe Province, Papua New Guinea. The outbreak resulted in at least five deaths, all in young children. Discussion: This outbreak of shigellosis highlights the threat of enteric diseases to vulnerable populations such as internally displaced persons in Papua New Guinea, as has been observed in other global settings.

Epidemiological investigation of an outbreak of hepatitis A in rural China

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Ping Yu

2015-04-01

Conclusion: The pattern of transmission in this outbreak was person-to-person, and the transmission route was indicated to be fecal–oral. In addition to close contact, insufficient hand-washing was a risk factor. Strengthening the management of the rural environmental sanitation services and enhancing awareness in the household are key to preventing outbreaks of hepatitis A in the future.

Origins and Implications of a Primary Crown-of-Thorns Starfish Outbreak in the Southern Great Barrier Reef

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Ian Miller

2015-01-01

Full Text Available The crown-of-thorns starfish (COTS is a major predator of hard corals. Repeated COTS outbreaks in the Cairns and Central sections of the Great Barrier Reef (GBR have been responsible for greater declines in coral cover than any other type of disturbance, including cyclones, disease, and coral bleaching. Knowledge of the precise timing and location of primary outbreaks could reveal the initial drivers of outbreaks and so could indicate possible management measures. In the central GBR, COTS outbreaks appear to follow major flooding events, but despite many years of observations, no primary outbreak has ever been unequivocally identified in the central and northern GBR. Here we locate a primary outbreak of COTS on the southern GBR which is not correlated with flooding. Instead it appears to have been the result of a combination of life history traits of COTS and prevailing oceanographic conditions. The hydrodynamic setting implies that the outbreak could disperse larvae to other reefs in the region.

Family Outbreaks of Nontyphoidal Salmonellosis following a Meal of Guinea Pigs

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John B. Fournier

2015-01-01

Full Text Available Salmonella outbreaks have been linked to a wide variety of foods, including recent nationwide outbreaks. Guinea pig (Cavia porcellus, also known as cuy or cobayo, has long been a popular delicacy and ceremonial food in the Andean region in South America. This case report describes three family outbreaks of nontyphoidal salmonellosis, each occurring after a meal of guinea pigs. We believe this case report is the first to describe a probable association between the consumption of guinea pig meat and human salmonellosis. Physicians should be aware of the association of Salmonella and the consumption of guinea pigs, given the increasing immigration of people from the Andean region of South America and the increasing travel to this region.

Lessons from the pandemic: the need for new tools for risk and outbreak communication.

Science.gov (United States)

Abraham, Thomas

2011-10-17

The influenza pandemic of 2009 revealed shortcomings in the existing guidelines for risk and outbreak communication. Concepts such as building trust proved hard to achieve in practice, whereas other issues such as communicating through the internet and coping with the political fallout of disease outbreaks are not dealt with in existing guidelines. This article surveys the current guidelines and makes recommendations for additional tools and guidelines to be developed in four areas: integrating long-term behavior change models with outbreak communications; research to develop a better understanding of communicating through the internet; research to understand how to use communications to build trust; and developing guidelines and principles to understand the political nature of disease outbreaks.

Outbreaks of paralytic poliomyelitis during 1996-2012: the changing epidemiology of a disease in the final stages of eradication.

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Mach, Ondrej; Tangermann, Rudolf H; Wassilak, Steve G; Singh, Simarjit; Sutter, Roland W

2014-11-01

Despite substantial progress toward eradication of poliomyelitis, the risk of poliomyelitis outbreaks resulting from virus importations into polio-free areas persists. We reviewed the changing epidemiology of outbreaks in the final stages of the eradication initiative. Available literature on outbreaks of poliomyelitis caused by wild polioviruses between 1996 and 2012 was reviewed. During this period, there were 22 outbreaks involving 39 countries. Outbreaks ranged in size from 1 to 1335 cases. These outbreaks caused 4571 cases, representing 21% of all cases reported during this period. Five outbreaks involved multiple countries. In 76% of outbreaks (16/21) with a known age distribution, cases concentrated among children aged poliomyelitis had not occurred for many years. The changing epidemiology, with cases and higher case-fatality ratios among adults, increased the severity of these outbreaks. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

[Surveillance Plan on Recent Outbreak of Measles and Rubella in Catalonia, Spain].

Science.gov (United States)

Jané, Mireia; Torner, Nuria; Vidal, Ma José

2015-01-01

Measles and rubella are two immuno-preventive illnesses. In Catalonia, since 1988 all children are given two doses of measles and rubella vaccine with high levels of vaccination coverage. The measles elimination programme has been carried out since 1990 in Catalonia. This programme includes achieving and keeping high immunization levels among population with high vaccination coverage, intense epidemiological surveillance and an immediate response to the appearance of a case or outbreak. In 2014, the measles incidence rate was 1.9 cases/ 100,000 inhabitants. There were 4 recent outbreaks in 2006, 2011, 2013 and 2014 that affected 381, 289, 31 and 124 people respectively. All outbreaks were triggered by an imported case. In 2011 and 2014 measles outbreaks, 6% and 5.5% of affected people were health care workers. All outbreaks presented a great variety of measles genotypes. Concerning rubella elimination programme, since 2002, 68 cases of postnatal rubella and 5 cases of congenital rubella were confirmed. Regarding measles and rubella surveillance and control, in addition to strengthen vaccination coverage, it is essential immediate notification, within the first 24 hours since suspicion and laboratory confirmation. In addition there is a need to enforce vaccination among health care workers as well as in other susceptible and unvaccinated people. It is recommended to vaccinate all people who were born after 1966 and who have not been vaccinated with two doses of trivalent measles-mumps-rubella vaccine. Furthermore, we have to emphasize that the progress concerning genotypes study allows identifying various imported cases from other European countries with active outbreaks, aspect that makes easier the surveillance of these illnesses.

Two nursing home outbreaks of respiratory infection with Legionella sainthelensi.

Science.gov (United States)

Loeb, M; Simor, A E; Mandell, L; Krueger, P; McArthur, M; James, M; Walter, S; Richardson, E; Lingley, M; Stout, J; Stronach, D; McGeer, A

1999-05-01

To describe outbreaks of infection caused by Legionella sainthelensi occurring in older residents of two nursing homes and to determine risk factors for the development of infection. Descriptive epidemiology and a case-control study. Two nursing homes (140 beds and 254 beds in nursing homes A and B, respectively) located in southern Ontario, Canada, experiencing outbreaks of respiratory tract infection in July and August 1994. Case-residents of the two nursing homes who met clinical and laboratory criteria for Legionella infection. Control-residents were defined as those who were in the homes during the outbreaks and were asymptomatic. Active surveillance was conducted in both nursing homes to identify symptomatic residents. Residents with fever or respiratory tract symptoms had nasopharyngeal swabs taken for viral antigen detection and culture, urine for Legionella antigen detection, and acute and convalescent serology for viruses, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella. Chest X-rays were performed, and an attempt was made to obtain blood and sputum cultures. Water samples from shower heads, faucets, and air conditioning units were collected for Legionella culture and polymerase chain reaction (PCR) assay. A case-control study was done to assess possible risk factors for legionellosis. Twenty-nine cases -- 17 in nursing home A; 12 in nursing home B - were identified. Four (14%) case-residents had documented pneumonia and four case-residents died. Univariate analysis revealed that a history of stroke (odds ratio (OR) 2.3 (95% CI, 1.0-5.3)), eating pureed food (OR 4.6 (95% CI, 1.6-12.7)), and having fluids administered with medication (OR 2.5 (95% CI, 1.0-5.9)) were significant risk factors. Cases were less likely to wear dentures (OR .4 (95% CI, .2-.9)) or to eat solid food (OR .3, (95% CI, .1-.6)). Only eating pureed food remained significant in a multivariable analysis (OR 4.6 (95% CI, 1.6-13.0, P = .01)). This report describes outbreaks of

Rapid MALDI-TOF Mass Spectrometry Strain Typing during a Large Outbreak of Shiga-Toxigenic Escherichia coli

Science.gov (United States)

Christner, Martin; Trusch, Maria; Rohde, Holger; Kwiatkowski, Marcel; Schlüter, Hartmut; Wolters, Manuel; Aepfelbacher, Martin; Hentschke, Moritz

2014-01-01

Background In 2011 northern Germany experienced a large outbreak of Shiga-Toxigenic Escherichia coli O104:H4. The large amount of samples sent to microbiology laboratories for epidemiological assessment highlighted the importance of fast and inexpensive typing procedures. We have therefore evaluated the applicability of a MALDI-TOF mass spectrometry based strategy for outbreak strain identification. Methods Specific peaks in the outbreak strain’s spectrum were identified by comparative analysis of archived pre-outbreak spectra that had been acquired for routine species-level identification. Proteins underlying these discriminatory peaks were identified by liquid chromatography tandem mass spectrometry and validated against publicly available databases. The resulting typing scheme was evaluated against PCR genotyping with 294 E. coli isolates from clinical samples collected during the outbreak. Results Comparative spectrum analysis revealed two characteristic peaks at m/z 6711 and m/z 10883. The underlying proteins were found to be of low prevalence among genome sequenced E. coli strains. Marker peak detection correctly classified 292 of 293 study isolates, including all 104 outbreak isolates. Conclusions MALDI-TOF mass spectrometry allowed for reliable outbreak strain identification during a large outbreak of Shiga-Toxigenic E. coli. The applied typing strategy could probably be adapted to other typing tasks and might facilitate epidemiological surveys as part of the routine pathogen identification workflow. PMID:25003758

[Orion (Outbreak Reports and Intervention studies of Nosocomial Infection) used for evaluating interventions and investigations of nosocomial infection outbreaks].

Science.gov (United States)

Pires-Cronenberger, S; Nicolle, M-C; Voirin, N; Giard, M; Luxemburger, C; Vanhems, P

2009-04-01

British colleagues have developed the Outbreak Reports and Intervention studies of Nosocomial Infection (Orion) guidelines with the aim to promote transparency of publications in the field of health-care associated infections and particularly for reports of outbreak investigation or intervention studies. The aim of this study was to translate the Orion criteria and to promote their use in France. The Orion guidelines include a checklist of 22 commented items related to the title, abstract, introduction, methods, results, and discussion sections of a scientific article. Specific points for each item are developed to enhance its relevance. The use of Orion guidelines by authors and editors should be encouraged and should improve the quality of standards in research, intervention studies, and publications on nosocomial infections and health-care associated infections.

October 2012 Multistate Fungal Meningitis Outbreak

Centers for Disease Control (CDC) Podcasts

2012-10-17

This podcast gives an overview of the October 2012 multistate fungal meningitis outbreak, including symptoms to watch for and a website for up-to-date information.  Created: 10/17/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 10/17/2012.

Genomics-enabled sensor platform for rapid detection of viruses related to disease outbreak.

Energy Technology Data Exchange (ETDEWEB)

Brozik, Susan M; Manginell, Ronald P; Moorman, Matthew W; Xiao, Xiaoyin; Edwards, Thayne L.; Anderson, John Moses; Pfeifer, Kent Bryant; Branch, Darren W.; Wheeler, David Roger; Polsky, Ronen; Lopez, DeAnna M.; Ebel, Gregory D.; Prasad, Abhishek N.; Brozik, James A.; Rudolph, Angela R.; Wong, Lillian P.

2013-09-01

Bioweapons and emerging infectious diseases pose growing threats to our national security. Both natural disease outbreak and outbreaks due to a bioterrorist attack are a challenge to detect, taking days after the outbreak to identify since most outbreaks are only recognized through reportable diseases by health departments and reports of unusual diseases by clinicians. In recent decades, arthropod-borne viruses (arboviruses) have emerged as some of the most significant threats to human health. They emerge, often unexpectedly, from cryptic transmission foci causing localized outbreaks that can rapidly spread to multiple continents due to increased human travel and trade. Currently, diagnosis of acute infections requires amplification of viral nucleic acids, which can be costly, highly specific, technically challenging and time consuming. No diagnostic devices suitable for use at the bedside or in an outbreak setting currently exist. The original goals of this project were to 1) develop two highly sensitive and specific diagnostic assays for detecting RNA from a wide range of arboviruses; one based on an electrochemical approach and the other a fluorescent based assay and 2) develop prototype microfluidic diagnostic platforms for preclinical and field testing that utilize the assays developed in goal 1. We generated and characterized suitable primers for West Nile Virus RNA detection. Both optical and electrochemical transduction technologies were developed for DNA-RNA hybridization detection and were implemented in microfluidic diagnostic sensing platforms that were developed in this project.

Food-initiated outbreak of methicillin-resistant Staphylococcus aureus analyzed by pheno- and genotyping

NARCIS (Netherlands)

J.A.J.W. Kluytmans (Jan); R. Hollis; S. Messer; L. Herwaldt; J. Bruining (Hans); M. Heck; J. Rost; N. van Leeuwen; W.H.F. Goessens (Wil); W.B. van Leeuwen (Willem)

1995-01-01

textabstractAn outbreak of methicillin-resistant Staphylococcus aureus (MRSA) involving 27 patients and 14 health-care workers (HCW) was studied. The outbreak started in the hematology unit of the University Hospital Rotterdam, Dijkzigt, The Netherlands, and spread to

A Waterborne Gastroenteritis Outbreak Caused by Norovirus GII.17 in a Hotel, Hebei, China, December 2014.

Science.gov (United States)

Qin, Meng; Dong, Xiao-Gen; Jing, Yan-Yan; Wei, Xiu-Xia; Wang, Zhao-E; Feng, Hui-Ru; Yu, Hong; Li, Jin-Song; Li, Jie

2016-09-01

Norovirus (NoV) is responsible for an estimated 90 % of all epidemic nonbacterial outbreaks of gastroenteritis worldwide. Waterborne outbreaks of NoV are commonly reported. A novel GII.17 NoV strain emerged as a major cause of gastroenteritis outbreaks in China during the winter of 2014/2015. During this time, an outbreak of gastroenteritis occurred at a hotel in a ski park in Hebei Province, China. Epidemiological investigations indicated that one water well, which had only recently been in use, was the probable source. GII.17 NoV was detected by real-time reverse-transcription polymerase chain reaction from samples taken from cases, from concentrated water samples from water well, and from the nearby sewage settling tank. Nucleotide sequences of NoV extracted from clinical and water specimens were genetically identical and had 99 % homology with Beijing/CHN/2015. All epidemiological data indicated that GII.17 NoV was responsible for this outbreak. This is the first reported laboratory-confirmed waterborne outbreak caused by GII.17 NoV genotype in China. Strengthening management of well drinking water and systematica monitoring of NoV is essential for preventing future outbreaks.

An Outbreak of Human Fascioliasis gigantica in Southwest China.

Science.gov (United States)

Chen, Jia-Xu; Chen, Mu-Xin; Ai, Lin; Xu, Xue-Nian; Jiao, Jian-Ming; Zhu, Ting-Jun; Su, Hui-Yong; Zang, Wei; Luo, Jia-Jun; Guo, Yun-Hai; Lv, Shan; Zhou, Xiao-Nong

2013-01-01

Fascioliasis is a common parasitic disease in livestock in China. However, human fascioliasis is rarely reported in the country. Here we describe an outbreak of human fascioliasis in Yunnan province. We reviewed the complete clinical records of 29 patients and performed an epidemiological investigation on the general human population and animals in the outbreak locality. Our findings support an outbreak due to Fasciola gigantica with a peak in late November, 2011. The most common symptoms were remittent fever, epigastric tenderness, and hepatalgia. Eosinophilia and tunnel-like lesions in ultrasound imaging in the liver were also commonly seen. Significant improvement of patients' condition was achieved by administration of triclabendazole®. Fasciola spp. were discovered in local cattle (28.6%) and goats (26.0%). Molecular evidence showed a coexistence of F. gigantica and F. hepatica. However, all eggs seen in humans were confirmed to be F. gigantica. Herb (Houttuynia cordata) was most likely the source of infections. Our findings indicate that human fascioliasis is a neglected disease in China. The distribution of triclabendazole®, the only efficacious drug against human fascioliasis, should be promoted.

[Waterborne outbreak of gastroenteritis transmitted through the public water supply].

Science.gov (United States)

Godoy, P; Borrull, C; Palà, M; Caubet, I; Bach, P; Nuín, C; Espinet, L; Torres, J; Mirada, G

2003-01-01

The chlorination of public water supplies has led researchers to largely discard drinking water as a potential source of gastroenteritis outbreaks. The aim of this study was to investigate an outbreak of waterborne disease associated with drinking water from public supplies. A historical cohort study was carried out following notification of a gastroenteritis outbreak in Baqueira (Valle de Arán, Spain). We used systematic sampling to select 87 individuals staying at hotels and 67 staying in apartments in the target area. Information was gathered on four factors (consumption of water from the public water supply, sandwiches, water and food in the ski resorts) as well as on symptoms. We assessed residual chlorine in drinking water, analyzed samples of drinking water, and studied stool cultures from 4 patients. The risk associated with each water source and food type was assessed by means of relative risk (RR) and 95% confidence intervals (CI). The overall attack rate was 51.0% (76/149). The main symptoms were diarrhea 87.5%, abdominal pain 80.0%, nausea 50.7%, vomiting 30.3%, and fever 27.0%. The only factor associated with a statistically significant risk of disease was consumption of drinking water (RR = 11.0; 95% CI, 1.6-74.7). No residual chlorine was detected in the drinking water, which was judged acceptable. A problem associated with the location of the chlorinator was observed and corrected. We also recommended an increase in chlorine levels, which was followed by a reduction in the number of cases. The results of stool cultures of the four patients were negative for enterobacteria. This study highlights the potential importance of waterborne outbreaks of gastroenteritis transmitted through drinking water considered acceptable and suggests the need to improve microbiological research into these outbreaks (viruses and protozoa detection).

Outbreak of epidemic keratoconjunctivitis caused by adenovirus in medical residents.

Science.gov (United States)

Melendez, Carlos Pantoja; Florentino, Margarita Matias; Martinez, Irma Lopez; Lopez, Herlinda Mejia

2009-01-01

The present work documents an outbreak of epidemic keratoconjunctivitis among ophthalmology residents, its influence in the presentation of the community cases, the use of molecular techniques for its diagnosis, and the implementation of successful control measures for its containment. Isolation of the etiologic agent was achieved using cultured African green monkey kidney epithelial cells (VERO). Through molecular tests, such as polymerase chain reaction (PCR) and DNA sequencing, the genotype of the isolated virus was identified. The sequences obtained were aligned with data reported in the NCBI GenBank. A scheme of outbreak control measures was designed to enforce correct sanitary measures in the clinic. The statistical program, Epi info 2002, and openepi were used to determine the attack rate. The Excel Microsoft program was used to elaborate the endemic channel. Nine of the ten samples studied were isolated from the culture and identified by Adenovirus-specifc PCR. Sequencing allowed identification of Ad8 as the agent responsible for the outbreak. The attack rate was 24.39 cases per 100. The epidemic curve allowed identification of a disseminated source in the Institute of Ophthalmology "Conde de Valenciana." It was not possible to calculate the incubation periods among the cases. The endemic channel showed the presence of an epidemic keratoconjunctivitis among the patients that had been cared for at the out-patient services of the institute. One outbreak of a disseminated source caused by Ad8 was detected in the institute among its medical residents, probably associated with relaxation of the habitual sanitary measures during an epidemic of hemorrhagic conjunctivitis among the patients cared for at the institute. The proposed scheme to control the outbreak allowed for its containment and controlled the epidemic of associated cases.

Using Outbreak Data for Source Attribution of Human Salmonellosis and Campylobacteriosis in Europe

DEFF Research Database (Denmark)

Pires, Sara Monteiro; Vigre, Håkan; Makela, Pia

2010-01-01

% of campylobacteriosis cases were attributed to chicken. Results also revealed regional differences in the relative importance of specific sources. We assessed the method to be of limited value to attribute human campylobacteriosis due to the limited number of outbreaks. Nevertheless, the presented source attribution...... are observed at the public health endpoint and can therefore be a direct measure of attribution at the point of exposure. An analysis or summary of outbreak investigations is useful for attributing illnesses to foods, but often the implicated foods in reported outbreaks are complex foods, containing several...... food items, many of which could be the specific source of the infection. We describe a method that is able to attribute human cases to specific food items contained in complex foods. The model is based on data from investigations of Salmonella and Campylobacter outbreaks in the European Union in 2005...

The 2010 outbreak of poliomyelitis in Tajikistan: epidemiology and lessons learnt.

Science.gov (United States)

Yakovenko, M L; Gmyl, A P; Ivanova, O E; Eremeeva, T P; Ivanov, A P; Prostova, M A; Baykova, O Y; Isaeva, O V; Lipskaya, G Y; Shakaryan, A K; Kew, O M; Deshpande, J M; Agol, V I

2014-02-20

A large outbreak of poliomyelitis, with 463 laboratory-confirmed and 47 polio-compatible cases, took place in 2010 in Tajikistan. Phylogenetic analysis of the viral VP1 gene suggested a single importation of wild poliovirus type 1 from India in late 2009, its further circulation in Tajikistan and expansion into neighbouring countries, namely Kazakhstan, Russia, Turkmenistan and Uzbekistan. Whole-genome sequencing of 14 isolates revealed recombination events with enterovirus C with cross-overs within the P2 region. Viruses with one class of recombinant genomes co-circulated with the parental virus, and representatives of both caused paralytic poliomyelitis. Serological analysis of 327 sera from acute flaccid paralysis cases as well as from patients with other diagnoses and from healthy people demonstrated inadequate immunity against polio in the years preceding the outbreak. Evidence was obtained suggesting that vaccination against poliomyelitis, in rare cases, may not prevent the disease. Factors contributing to the peculiarities of this outbreak are discussed. The outbreak emphasises the necessity of continued vaccination against polio and the need, at least in risk areas, of quality control of this vaccination through well planned serological surveillance.

Yersinia enterocolitica outbreak associated with ready-to-eat salad mix, Norway, 2011.

Science.gov (United States)

MacDonald, Emily; Heier, Berit Tafjord; Nygård, Karin; Stalheim, Torunn; Cudjoe, Kofitsyo S; Skjerdal, Taran; Wester, Astrid Louise; Lindstedt, Bjørn-Arne; Stavnes, Trine-Lise; Vold, Line

2012-09-01

In 2011, an outbreak of illness caused by Yersinia enterocolitica O:9 in Norway was linked to ready-to-eat salad mix, an unusual vehicle for this pathogen. The outbreak illustrates the need to characterize isolates of this organism, and reinforces the need for international traceback mechanisms for fresh produce.

Typhoid outbreak investigation in Dzivaresekwa, suburb of Harare ...

African Journals Online (AJOL)

Typhoid outbreak investigation in Dzivaresekwa, suburb of Harare City, Zimbabwe, 2011. Monica Muti, Notion Gombe, Mufuta Tshimanga, Lucia Takundwa, Donewell Bangure, Stanley Mungofa, Prosper Chonzi ...

Surveillance for waterborne disease and outbreaks associated with recreational water--United States, 2003-2004.

Science.gov (United States)

Dziuban, Eric J; Liang, Jennifer L; Craun, Gunther F; Hill, Vincent; Yu, Patricia A; Painter, John; Moore, Matthew R; Calderon, Rebecca L; Roy, Sharon L; Beach, Michael J

2006-12-22

Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System for collecting and reporting waterborne disease and outbreak (WBDO)-related data. In 1978, WBDOs associated with recreational water (natural and treated water) were added. This system is the primary source of data regarding the scope and effects of WBDOs in the United States. Data presented summarize WBDOs associated with recreational water that occurred during January 2003-December 2004 and one previously unreported outbreak from 2002. Public health departments in the states, territories, localities, and the Freely Associated States (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) have primary responsibility for detecting, investigating, and voluntarily reporting WBDOs to CDC. Although the surveillance system includes data for WBDOs associated with drinking water, recreational water, and water not intended for drinking, only cases and outbreaks associated with recreational water are summarized in this report. During 2003-2004, a total 62 WBDOs associated with recreational water were reported by 26 states and Guam. Illness occurred in 2,698 persons, resulting in 58 hospitalizations and one death. The median outbreak size was 14 persons (range: 1-617 persons). Of the 62 WBDOs, 30 (48.4%) were outbreaks of gastroenteritis that resulted from infectious agents, chemicals, or toxins; 13 (21.0%) were outbreaks of dermatitis; and seven (11.3%) were outbreaks of acute respiratory illness (ARI). The remaining 12 WBDOs resulted in primary amebic meningoencephalitis (n = one), meningitis (n = one), leptospirosis (n = one), otitis externa (n = one), and mixed illnesses (n = eight). WBDOs associated with gastroenteritis resulted in 1,945 (72

Transmission patterns of smallpox: systematic review of natural outbreaks in Europe and North America since World War II

Directory of Open Access Journals (Sweden)

Boer Rob

2006-05-01

Full Text Available Abstract Background Because smallpox (variola major may be used as a biological weapon, we reviewed outbreaks in post-World War II Europe and North America in order to understand smallpox transmission patterns. Methods A systematic review was used to identify papers from the National Library of Medicine, Embase, Biosis, Cochrane Library, Defense Technical Information Center, WorldCat, and reference lists of included publications. Two authors reviewed selected papers for smallpox outbreaks. Results 51 relevant outbreaks were identified from 1,389 publications. The median for the effective first generation reproduction rate (initial R was 2 (range 0–38. The majority outbreaks were small (less than 5 cases and contained within one generation. Outbreaks with few hospitalized patients had low initial R values (median of 1 and were prolonged if not initially recognized (median of 3 generations; outbreaks with mostly hospitalized patients had higher initial R values (median 12 and were shorter (median of 3 generations. Index cases with an atypical presentation of smallpox were less likely to have been diagnosed with smallpox; outbreaks in which the index case was not correctly diagnosed were larger (median of 27.5 cases and longer (median of 3 generations compared to outbreaks in which the index case was correctly diagnosed (median of 3 cases and 1 generation. Conclusion Patterns of spread during Smallpox outbreaks varied with circumstances, but early detection and implementation of control measures is a most important influence on the magnitude of outbreaks. The majority of outbreaks studied in Europe and North America were controlled within a few generations if detected early.

Investigating an outbreak of acute fever in Chuuk, Federated States of Micronesia

Directory of Open Access Journals (Sweden)

Damian Hoy

2014-11-01

Full Text Available Objective: In September 2012, there was an unexpected increase of acute febrile illness (AFI in Chuuk State of the Federated States of Micronesia. At the same time, dengue outbreaks were occurring in two of the Federated States of Micronesia’s other three states. The cause of AFI was suspected to be dengue; however, by the end of October, only one of 39 samples was positive for dengue. The objective of the investigation was to establish the cause of the outbreak. Methods: A line list was created and data analysed by time, place, person and clinical features. Reported symptoms were compared with the published symptoms of several diagnoses and laboratory testing undertaken. Results: Of the 168 suspected cases, 62% were less than 20 years of age and 60% were male. The clinical features of the cases were not typical for dengue but suggestive of respiratory illness. Nasopharyngeal swabs were subsequently collected and found to be positive for influenza. Public health measures were undertaken and the AFI returned to expected levels. Discussion: Clinical diagnosis of acute febrile illness (AFI can often be difficult and misleading. This can mean that opportunities for preventive measures early on in an outbreak are missed. In any outbreak, descriptive epidemiological analyses are valuable in helping to ascertain the cause of the outbreak.

Epidemiological investigation of an outbreak of cutaneous sporotrichosis, Northern Territory, Australia.

Science.gov (United States)

McGuinness, Sarah L; Boyd, Rowena; Kidd, Sarah; McLeod, Charlie; Krause, Vicki L; Ralph, Anna P

2016-01-13

An outbreak of cutaneous sporotrichosis occurred in the Darwin region of the Northern Territory (NT) in 2014. We aimed to determine the source and risk factors associated with the outbreak and describe the clinical spectrum of cases seen. Epidemiological investigation of cases of cutaneous sporotrichosis identified through the Royal Darwin Hospital was undertaken to investigate risk factors and potential sources of infection. Data were collected through chart review and individual patient interviews. Environmental investigation followed identification of a common risk factor. Nine confirmed cases of cutaneous sporotrichosis caused by Sporothrix schenckii were identified with onset of symptoms between April and July 2014. Patients were aged 29 to 70 years and seven were male (78%). Two strains of S. schenckii were identified, neither of which have been previously documented. One common risk factor was identified: all patients were occupational or recreational gardeners, with each reporting exposure to mulching hay, originating from a single NT farm. Local environmental health officers visited the farm and the owners confirmed that the implicated hay had been stored over the monsoon season and had been affected by rain. Storage of hay over the wet season was a new practice. This constitutes the third reported outbreak of S. schenckii sporotrichosis attributable to contaminated hay in Australia and the first outbreak of sporotrichosis in the NT. This outbreak prompted public health interventions, including distribution of information to general practitioners, farmers and suppliers in the Top End. Media reporting led to the identification and treatment of an additional case. Local practitioners should remain alert to the possibility of further occurrences of sporotrichosis.

Massively multiplexed microbial identification using resequencing DNA microarrays for outbreak investigation

Science.gov (United States)

Leski, T. A.; Ansumana, R.; Jimmy, D. H.; Bangura, U.; Malanoski, A. P.; Lin, B.; Stenger, D. A.

2011-06-01

Multiplexed microbial diagnostic assays are a promising method for detection and identification of pathogens causing syndromes characterized by nonspecific symptoms in which traditional differential diagnosis is difficult. Also such assays can play an important role in outbreak investigations and environmental screening for intentional or accidental release of biothreat agents, which requires simultaneous testing for hundreds of potential pathogens. The resequencing pathogen microarray (RPM) is an emerging technological platform, relying on a combination of massively multiplex PCR and high-density DNA microarrays for rapid detection and high-resolution identification of hundreds of infectious agents simultaneously. The RPM diagnostic system was deployed in Sierra Leone, West Africa in collaboration with Njala University and Mercy Hospital Research Laboratory located in Bo. We used the RPM-Flu microarray designed for broad-range detection of human respiratory pathogens, to investigate a suspected outbreak of avian influenza in a number of poultry farms in which significant mortality of chickens was observed. The microarray results were additionally confirmed by influenza specific real-time PCR. The results of the study excluded the possibility that the outbreak was caused by influenza, but implicated Klebsiella pneumoniae as a possible pathogen. The outcome of this feasibility study confirms that application of broad-spectrum detection platforms for outbreak investigation in low-resource locations is possible and allows for rapid discovery of the responsible agents, even in cases when different agents are suspected. This strategy enables quick and cost effective detection of low probability events such as outbreak of a rare disease or intentional release of a biothreat agent.

Hepatitis A outbreak on a floating restaurant in Florida, 1986.

Science.gov (United States)

Lowry, P W; Levine, R; Stroup, D F; Gunn, R A; Wilder, M H; Konigsberg, C

1989-01-01

In April and May 1986, the largest reported foodborne outbreak of hepatitis A in Florida state history occurred among patrons and employees of a floating restaurant. A total of 103 cases (97 patrons and six employees) were identified. The exposure period lasted 31 days (March 20-April 19), making this the most prolonged hepatitis A outbreak to occur in a restaurant that to date has been reported to the Centers for Disease Control. The exposure period was divided into time intervals (peak, early, late, and total) for calculation of food-specific attack rates. The authors showed that green salad was an important vehicle of transmission for each phase of the exposure period, with the highest adjusted odds ratio for the three-day peak exposure interval (March 28-30), 6.8 (p = 0.001). Non-salad pantry items and mixed bar drinks were also identified as vehicles of transmission; both were more important during the early interval of the exposure period than during the late interval. Two of six infected employees worked in the pantry and may have sequentially infected patrons. Though rare, this outbreak suggests that hepatitis A infection among employees may allow for transmission to patrons for prolonged periods of time. Prevention of such outbreaks requires prompt reporting of ill patrons with rapid identification of infected employees and correction of food handling practices.

Key data for outbreak evaluation: building on the Ebola experience.

Science.gov (United States)

Cori, Anne; Donnelly, Christl A; Dorigatti, Ilaria; Ferguson, Neil M; Fraser, Christophe; Garske, Tini; Jombart, Thibaut; Nedjati-Gilani, Gemma; Nouvellet, Pierre; Riley, Steven; Van Kerkhove, Maria D; Mills, Harriet L; Blake, Isobel M

2017-05-26

Following the detection of an infectious disease outbreak, rapid epidemiological assessment is critical for guiding an effective public health response. To understand the transmission dynamics and potential impact of an outbreak, several types of data are necessary. Here we build on experience gained in the West African Ebola epidemic and prior emerging infectious disease outbreaks to set out a checklist of data needed to: (1) quantify severity and transmissibility; (2) characterize heterogeneities in transmission and their determinants; and (3) assess the effectiveness of different interventions. We differentiate data needs into individual-level data (e.g. a detailed list of reported cases), exposure data (e.g. identifying where/how cases may have been infected) and population-level data (e.g. size/demographics of the population(s) affected and when/where interventions were implemented). A remarkable amount of individual-level and exposure data was collected during the West African Ebola epidemic, which allowed the assessment of (1) and (2). However, gaps in population-level data (particularly around which interventions were applied when and where) posed challenges to the assessment of (3). Here we highlight recurrent data issues, give practical suggestions for addressing these issues and discuss priorities for improvements in data collection in future outbreaks.This article is part of the themed issue 'The 2013-2016 West African Ebola epidemic: data, decision-making and disease control'. © 2017 The Authors.

Framework for evaluating public health surveillance systems for early detection of outbreaks: recommendations from the CDC Working Group.

Science.gov (United States)

Buehler, James W; Hopkins, Richard S; Overhage, J Marc; Sosin, Daniel M; Tong, Van

2004-05-07

The threat of terrorism and high-profile disease outbreaks has drawn attention to public health surveillance systems for early detection of outbreaks. State and local health departments are enhancing existing surveillance systems and developing new systems to better detect outbreaks through public health surveillance. However, information is limited about the usefulness of surveillance systems for outbreak detection or the best ways to support this function. This report supplements previous guidelines for evaluating public health surveillance systems. Use of this framework is intended to improve decision-making regarding the implementation of surveillance for outbreak detection. Use of a standardized evaluation methodology, including description of system design and operation, also will enhance the exchange of information regarding methods to improve early detection of outbreaks. The framework directs particular attention to the measurement of timeliness and validity for outbreak detection. The evaluation framework is designed to support assessment and description of all surveillance approaches to early detection, whether through traditional disease reporting, specialized analytic routines for aberration detection, or surveillance using early indicators of disease outbreaks, such as syndromic surveillance.

Sverdlovsk Anthrax Outbreak: An Educational Case Study

Science.gov (United States)

Steele, S. J.; van der Vink, G.

2002-05-01

In April and May of 1979 an Anthrax epidemic broke out in the city of Sverdlovsk (now Ekaterinburg) in the former Soviet Union. Sixty-four people were reported to have died from the outbreak, although there is still debate concerning the actual number of victims. While Soviet officials initially attributed this outbreak to contaminated meat, the US Government maintained that the outbreak was due to a leakage from a biological weapons facility. We have created and implemented an undergraduate educational exercise based on the forensic analysis of this event. Students were provided case data of the victims, area satellite images and meteorological data. One goal of the exercise was for students to reconstruct the most probable scenario of events through valid inference based on the limited information and uncertainties associated with the data set. Another goal was to make students sensitive to issues of biological weapons and bioterrorism. The exercise was highly rated by students even before the events of September 11. There is a clear need to educate students, particularly in the sciences, to be aware of the signatures of terrorist activities. Evidence of terrorist activities is more likely to appear from unintended discoveries than from active intelligence gathering. We believe our national security can be enhanced by sensitizing those that monitor the natural environment to the signatures of terrorist activities through the types of educational exercises that we have developed.

Defining Moments in MMWR History: 1993 E. coli> O157:H7 Hamburger Outbreak

Centers for Disease Control (CDC) Podcasts

During the 1993 E. coli O157 outbreak, four children died, and approximately 700 persons in four states became ill with severe and often bloody diarrhea after eating hamburgers from fast food restaurants. The first reports of CDC's investigation into this deadly outbreak were published in MMWR. In this podcast, Dr. Beth Bell shares what it was like to serve as one of CDC's lead investigators - a boots-on-the-ground disease detective -- for the historic outbreak.

Multidrug-Resistant Bacterial Outbreaks in Burn Units: A Synthesis of the Literature According to the ORION Statement.

Science.gov (United States)

Girerd-Genessay, Isabelle; Bénet, Thomas; Vanhems, Philippe

2016-01-01

The objective of this study is to review the literature on multidrug-resistant bacteria (MDRB) outbreaks in burn units according to the outbreak reports and intervention studies of nosocomial infection statement. A PubMed search engine was enlisted to identify reports, in English and French, on MDRB outbreaks in burn units, with no date restrictions, using the following key words: ("burn" OR "burns" OR "severe burn") AND ("unit" OR "critical care" OR "acute care" OR "intensive care" OR "center" OR "centre" OR "department") AND ("outbreak" OR "epidemic") AND ("resistant" OR "multidrug-resistant" OR "resistance" OR "MDR" OR "MDRO"). Twenty-nine articles on such outbreaks in burn units were analyzed. A wide variety of these outbreaks were studied in terms of the microbial agents involved, length of outbreak, and attack rate (1.9-66.7%). The most frequent bacteria were methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii. Screening of staff revealed carrier rates of 0 to 20% in 16 studies. Environmental samples were taken in 21 studies and were positive in 14 of them. The mortality rate among infected patients varied from 0 to 33%. Implementation of isolation precautions did not always suffice, with unit closure being necessary in five outbreaks. The lack of consensus on how to manage such outbreak was highlighted. MDRB infections or colonizations are responsible for increased morbidity and mortality in vulnerable burn patients. Their management is problematic because of multifactorial transmission and limited therapeutic possibilities.

Four linked outbreaks of Salmonella enteritidis phage type 4 infection--the continuing egg threat.

Science.gov (United States)

Ejidokun, O O; Killalea, D; Cooper, M; Holmyard, S; Cross, A; Kemp, C

2000-06-01

Four outbreaks of Salmonella enteritidis phage type (PT) 4 occurred among guests at functions for which a single commercial caterer supplied food. Retrospective cohort studies were used to describe the epidemiology of three of these outbreaks and identify the vehicle(s) responsible. Of 172 guests at these three events, 47 fitted the clinical case definition for illness and 24 cases were confirmed to have S. enteritidis PT4 infection. Food containing raw egg was identified epidemiologically as the likely vehicle of infection in two of the three outbreaks (odds ratios (OR) and 95% confidence intervals 9.1 (2.2-39.9) and 6.9 (1.2-46.4)). Logistic regression analysis yielded OR = 10.7 (p = 0.0022) and OR = 9.3 (p = 0.015) for egg consumption in two of the outbreaks. These outbreaks highlighted the continuing need to remind the public and commercial caterers of the potential high risks of contracting salmonella from shell eggs. Education of caterers includes advice to obtain eggs and other products from reputable and identifiable suppliers.

Phase-dependent outbreak dynamics of geometrid moth linked to host plant phenology.

Science.gov (United States)

Jepsen, Jane U; Hagen, Snorre B; Karlsen, Stein-Rune; Ims, Rolf A

2009-12-07

Climatically driven Moran effects have often been invoked as the most likely cause of regionally synchronized outbreaks of insect herbivores without identifying the exact mechanism. However, the degree of match between host plant and larval phenology is crucial for the growth and survival of many spring-feeding pest insects, suggesting that a phenological match/mismatch-driven Moran effect may act as a synchronizing agent. We analyse the phase-dependent spatial dynamics of defoliation caused by cyclically outbreaking geometrid moths in northern boreal birch forest in Fennoscandia through the most recent massive outbreak (2000-2008). We use satellite-derived time series of the prevalence of moth defoliation and the onset of the growing season for the entire region to investigate the link between the patterns of defoliation and outbreak spread. In addition, we examine whether a phase-dependent coherence in the pattern of spatial synchrony exists between defoliation and onset of the growing season, in order to evaluate if the degree of matching phenology between the moth and their host plant could be the mechanism behind a Moran effect. The strength of regional spatial synchrony in defoliation and the pattern of defoliation spread were both highly phase-dependent. The incipient phase of the outbreak was characterized by high regional synchrony in defoliation and long spread distances, compared with the epidemic and crash phase. Defoliation spread was best described using a two-scale stratified spread model, suggesting that defoliation spread is governed by two processes operating at different spatial scale. The pattern of phase-dependent spatial synchrony was coherent in both defoliation and onset of the growing season. This suggests that the timing of spring phenology plays a role in the large-scale synchronization of birch forest moth outbreaks.

Investigation of an outbreak of Salmonella enterica serovar Newport infection.

Science.gov (United States)

Irvine, W N; Gillespie, I A; Smyth, F B; Rooney, P J; McClenaghan, A; Devine, M J; Tohani, V K

2009-10-01

A large outbreak of Salmonella enterica serotype Newport infection occurred in Northern Ireland during September and October 2004. Typing of isolates from patients confirmed that this strain was indistinguishable from that in concurrent outbreaks in regions of England, in Scotland and in the Isle of Man. A total of 130 cases were distributed unequally across local government district areas in Northern Ireland. The epidemic curve suggested a continued exposure over about 4 weeks. A matched case-control study of 23 cases and 39 controls found a statistically significant association with a history of having eaten lettuce in a meal outside the home and being a case (odds ratio 23.7, 95% confidence interval 1.4-404.3). This exposure was reported by 57% of cases. Although over 300 food samples were tested, none yielded any Salmonella spp. Complexity and limited traceability in salad vegetable distribution hindered further investigation of the ultimate source of the outbreak.

Analytical report of the 2016 dengue outbreak in Córdoba city, Argentina

Directory of Open Access Journals (Sweden)

Camilo Rotela

2017-11-01

Full Text Available After elimination of the Aedes aegypti vector in South America in the 1960s, dengue outbreaks started to reoccur during the 1990s; strongly in Argentina since 1998. In 2016, Córdoba City had the largest dengue outbreak in its history. In this article we report this outbreak including spatio-temporal analysis of cases and vectors in the city. A total of 653 dengue cases were recorded by the laboratory-based dengue surveillance system and georeferenced by their residential addresses. Case maps were generated from the epidemiological week 1 (beginning of January to week 19 (mid-May. Dengue outbreak temporal evolution was analysed globally and three specific, high-incidence zones were detected using Knox analysis to characterising its spatio-temporal attributes. Field and remotely sensed data were collected and analysed in real time and a vector presence map based on the MaxEnt approach was generated to define hotspots, towards which the pesticide- based strategy was then targeted. The recorded pattern of cases evolution within the community suggests that dengue control measures should be improved.

Imported dengue from 2013 Angola outbreak: Not just serotype 1 was detected.

Science.gov (United States)

Abreu, Cândida; Silva-Pinto, André; Lazzara, Daniela; Sobrinho-Simões, Joana; Guimarães, João Tiago; Sarmento, António

2016-06-01

All the reports from Angola's 2013 dengue outbreak revealed serotype 1. However, previously dengue serotypes 1-4 have been reported in Africa and in 2014 serotype 4 was reported in Angola. To report dengue serotypes in patients returning from Angola during 2013 outbreak. Retrospective, cross-sectional study. We serotyped the dengue by an in house Polymerase Chain Reaction technique in randomly selected cases. From the 2013 Angola's dengue outbreak we treated 47 adult patients. None had history of past dengue. A combo kit test for dengue revealed positive NS1 antigen in 39 and IgM antibodies in 8. From 17 randomly patients tested by RNA Real Time-PCR, 11 were positive: 7 for DENV-1, 2 for DENV-2, 1 for DENV-3 (co-infected with DENV-1) and 1 for DENV-4. None had a complicated or fatal evolution. Unlike previous reports the 4 serotypes were detected, and this resulted in a different epidemiological situation, raising the risk of future outbreaks of severe dengue. Copyright © 2016 Elsevier B.V. All rights reserved.

Utility of Whole-Genome Sequencing in Characterizing Acinetobacter Epidemiology and Analyzing Hospital Outbreaks

Science.gov (United States)

Fitzpatrick, Margaret A.; Hauser, Alan R.

2015-01-01

Acinetobacter baumannii frequently causes nosocomial infections and outbreaks. Whole-genome sequencing (WGS) is a promising technique for strain typing and outbreak investigations. We compared the performance of conventional methods with WGS for strain typing clinical Acinetobacter isolates and analyzing a carbapenem-resistant A. baumannii (CRAB) outbreak. We performed two band-based typing techniques (pulsed-field gel electrophoresis and repetitive extragenic palindromic-PCR), multilocus sequence type (MLST) analysis, and WGS on 148 Acinetobacter calcoaceticus-A. baumannii complex bloodstream isolates collected from a single hospital from 2005 to 2012. Phylogenetic trees inferred from core-genome single nucleotide polymorphisms (SNPs) confirmed three Acinetobacter species within this collection. Four major A. baumannii clonal lineages (as defined by MLST) circulated during the study, three of which are globally distributed and one of which is novel. WGS indicated that a threshold of 2,500 core SNPs accurately distinguished A. baumannii isolates from different clonal lineages. The band-based techniques performed poorly in assigning isolates to clonal lineages and exhibited little agreement with sequence-based techniques. After applying WGS to a CRAB outbreak that occurred during the study, we identified a threshold of 2.5 core SNPs that distinguished nonoutbreak from outbreak strains. WGS was more discriminatory than the band-based techniques and was used to construct a more accurate transmission map that resolved many of the plausible transmission routes suggested by epidemiologic links. Our study demonstrates that WGS is superior to conventional techniques for A. baumannii strain typing and outbreak analysis. These findings support the incorporation of WGS into health care infection prevention efforts. PMID:26699703

The outbreak of SARS at Tan Tock Seng Hospital--relating epidemiology to control.

Science.gov (United States)

Chen, Mark I C; Leo, Yee-Sin; Ang, Brenda S P; Heng, Bee-Hoon; Choo, Philip

2006-05-01

The outbreak of severe acute respiratory syndrome (SARS) began after the index case was admitted on 1 March 2003. We profile the cases suspected to have acquired the infection in Tan Tock Seng Hospital (TTSH), focussing on major transmission foci, and also describe and discuss the impact of our outbreak control measures. Using the World Health Organization (WHO) case definitions for probable SARS adapted to the local context, we studied all cases documented to have passed through TTSH less than 10 days prior to the onset of fever. Key data were collected in liaison with clinicians and through a team of onsite epidemiologists. There were 105 secondary cases in TTSH. Healthcare staff (57.1%) formed the majority, followed by visitors (30.5%) and inpatients (12.4%). The earliest case had onset of fever on 4 March 2003, and the last case, on 5 April 2003. Eighty-nine per cent had exposures to 7 wards which had cases of SARS that were not isolated on admission. In 3 of these wards, major outbreaks resulted, each with more than 20 secondary cases. Attack rates amongst ward-based staff ranged from 0% to 32.5%. Of 13 inpatients infected, only 4 (30.8%) had been in the same room or cubicle as the index case for the ward. The outbreak of SARS at TTSH showed the challenges of dealing with an emerging infectious disease with efficient nosocomial spread. Super-spreading events and initial delays in outbreak response led to widespread dissemination of the outbreak to multiple wards.

Nosocomial outbreak of staphyloccocal scalded skin syndrome in neonates in England, December 2012 to March 2013.

Science.gov (United States)

Paranthaman, K; Bentley, A; Milne, L M; Kearns, A; Loader, S; Thomas, A; Thompson, F; Logan, M; Newitt, S; Puleston, R

2014-08-21

Staphylococcal scalded skin syndrome (SSSS) is a blistering skin condition caused by exfoliative toxin-producing strains of Staphylococcus aureus. Outbreaks of SSSS in maternity settings are rarely reported. We describe an outbreak of SSSS that occurred among neonates born at a maternity unit in England during December 2012 to March 2013. Detailed epidemiological and microbiological investigations were undertaken. Eight neonates were found to be infected with the outbreak strain of S. aureus, of spa type t346, representing a single pulsotype. All eight isolates contained genes encoding exfoliative toxin A (eta) and six of them contained genes encoding toxin B (etb). Nasal swabs taken during targeted staff screening yielded a staphylococcal carriage rate of 21% (17/80), but none contained the outbreak strain. Mass screening involving multi-site swabbing and pooled, enrichment culture identified a healthcare worker (HCW) with the outbreak strain. This HCW was known to have a chronic skin condition and their initial nasal screen was negative. The outbreak ended when they were excluded from work. This outbreak highlights the need for implementing robust swabbing and culture methodswhen conventional techniques are unsuccessful in identifying staff carrier(s). This study adds to the growing body of evidence on the role of HCWs in nosocomial transmission of S. aureus.

Individualistic values are related to an increase in the outbreaks of infectious diseases and zoonotic diseases.

Science.gov (United States)

Morand, Serge; Walther, Bruno A

2018-03-01

Collectivist versus individualistic values are important attributes of intercultural variation. Collectivist values favour in-group members over out-group members and may have evolved to protect in-group members against pathogen transmission. As predicted by the pathogen stress theory of cultural values, more collectivist countries are associated with a higher historical pathogen burden. However, if lifestyles of collectivist countries indeed function as a social defence which decreases pathogen transmission, then these countries should also have experienced fewer disease outbreaks in recent times. We tested this novel hypothesis by correlating the values of collectivism-individualism for 66 countries against their historical pathogen burden, recent number of infectious disease outbreaks and zoonotic disease outbreaks and emerging infectious disease events, and four potentially confounding variables. We confirmed the previously established negative relationship between individualism and historical pathogen burden with new data. While we did not find a correlation for emerging infectious disease events, we found significant positive correlations between individualism and the number of infectious disease outbreaks and zoonotic disease outbreaks. Therefore, one possible cost for individualistic cultures may be their higher susceptibility to disease outbreaks. We support further studies into the exact protective behaviours and mechanisms of collectivist societies which may inhibit disease outbreaks.

Importance of Multifaceted Approaches in Infection Control: A Practical Experience from an Outbreak Investigation.

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Nina Katharina Stock

Full Text Available This study presents the results of a multidisciplinary, nosocomial MRSA outbreak investigation in an 8-bed medical intensive care unit (ICU. The identification of seven MRSA positive patients in the beginning of 2014 led to the closure of the ward for several weeks. A multidisciplinary, retrospective investigation was initiated in order to identify the reason and the source for the outbreak, describe MRSA transmission in the department and identify limitations in infection control.The investigation comprised an epidemiological description of MRSA cases from 2012 to 2014 and a characterization of MRSA isolates, including phage-, spa- and PFGE-typing. Additionally, MRSA screening was performed from the hospital staff and the environment. To identify the reason for the outbreak, work-related, psychological and behavioral factors were investigated by impartial audits and staff interviews.Thirty-one MRSA cases were registered during the study period, and 36 isolates were investigated. Molecular typing determined the outbreak strain (phage type 54/812, PFGE type A4, spa type t003 and identified the probable index case. Nasal carriage in one employee and a high environmental contamination with the outbreak strain was documented. Important gaps in nursing procedures and general management were identified. Elevated stress levels and communication problems preceded the outbreak. Compliance with hand hygiene and isolation procedures was evaluated as appropriate.This study demonstrates the complexity of controlling hospital-associated infections. The combined use of different typing methods is beneficial for outbreak investigations. Psychological, behavioral and other work-related factors have an important impact on the spread of nosocomial pathogens. These factors should be addressed and integrated in routine infection control practice.

Sapovirus Outbreaks in Long-Term Care Facilities

Centers for Disease Control (CDC) Podcasts

2012-06-21

Lore Elizabeth Lee, a clinical epidemiologist at the Oregon Public Health Division, discusses sapovirus outbreaks, testing, and treatment.  Created: 6/21/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/21/2012.

Epidemiology of multiple Acinetobacter outbreaks in The Netherlands during the period 1999-2001

NARCIS (Netherlands)

van den Broek, P. J.; Arends, J.; Bernards, A. T.; De Brauwer, E.; Mascini, E. M.; van der Reijden, T. J. K.; Spanjaard, L.; Thewessen, E. A. P. M.; van der Zee, A.; van Zeijl, J. H.; Dijkshoorn, L.

An increase in the number of outbreaks of Acinetobacter infection was notified in The Netherlands during 1999-2001. The present study compared the outbreaks at the species and strain levels, and analysed the epidemiology and control measures at the different locations. For each institute, three

Role of contact tracing in containing the 2014 Ebola outbreak: a review

African Journals Online (AJOL)

Background: The 2014 outbreak of Ebola virus disease which emerged in the month of March in the year 2014 in Guinea has been declared as a public health emergency of international concern. Objectives: The objectives of the review article are to assess the role of contact tracing in the Ebola outbreak and to identify the ...

High Hand Contamination Rates During Norovirus Outbreaks in Long-Term Care Facilities.

Science.gov (United States)

Park, Geun Woo; Williamson, Keenan J; DeBess, Emilio; Cieslak, Paul R; Gregoricus, Nicole; De Nardo, Elizabeth; Fricker, Christopher; Costantini, Verónica; Vinjé, Jan

2018-02-01

We examined norovirus contamination on hands of ill patients during 12 norovirus outbreaks in 12 long-term care facilities (LTCFs). The higher frequency and norovirus titers on hands of residents compared to hands of heathcare workers highlights the importance of adhering to appropriate hand hygiene practices during norovirus outbreaks in LTCFs. Infect Control Hosp Epidemiol 2018;39:219-221.

Functional Characterization of Adaptive Mutations during the West African Ebola Virus Outbreak.

Science.gov (United States)

Dietzel, Erik; Schudt, Gordian; Krähling, Verena; Matrosovich, Mikhail; Becker, Stephan

2017-01-15

The Ebola virus (EBOV) outbreak in West Africa started in December 2013, claimed more than 11,000 lives, threatened to destabilize a whole region, and showed how easily health crises can turn into humanitarian disasters. EBOV genomic sequences of the West African outbreak revealed nonsynonymous mutations, which induced considerable public attention, but their role in virus spread and disease remains obscure. In this study, we investigated the functional significance of three nonsynonymous mutations that emerged early during the West African EBOV outbreak. Almost 90% of more than 1,000 EBOV genomes sequenced during the outbreak carried the signature of three mutations: a D759G substitution in the active center of the L polymerase, an A82V substitution in the receptor binding domain of surface glycoprotein GP, and an R111C substitution in the self-assembly domain of RNA-encapsidating nucleoprotein NP. Using a newly developed virus-like particle system and reverse genetics, we found that the mutations have an impact on the functions of the respective viral proteins and on the growth of recombinant EBOVs. The mutation in L increased viral transcription and replication, whereas the mutation in NP decreased viral transcription and replication. The mutation in the receptor binding domain of the glycoprotein GP improved the efficiency of GP-mediated viral entry into target cells. Recombinant EBOVs with combinations of the three mutations showed a growth advantage over the prototype isolate Makona C7 lacking the mutations. This study showed that virus variants with improved fitness emerged early during the West African EBOV outbreak. The dimension of the Ebola virus outbreak in West Africa was unprecedented. Amino acid substitutions in the viral L polymerase, surface glycoprotein GP, and nucleocapsid protein NP emerged, were fixed early in the outbreak, and were found in almost 90% of the sequences. Here we showed that these mutations affected the functional activity of

Series of Norovirus Outbreaks Caused by Consumption of Green Coral Lettuce, Denmark, April 2016

DEFF Research Database (Denmark)

Müller, Luise; Rasmussen, Lasse Dam; Jensen, Tenna

2016-01-01

In early April 2016, an unusual high number of point-source outbreaks of gastrointestinal disease were reported to occur in Denmark. Outbreaks were individually investigated. Two analytical studies were performed. Patient stool samples collected and analysed; positive stool samples were sequenced...... over the polymerase and/or capsid gene areas. Implicated lettuce heads were collected and analysed for the presence of norovirus. Foods were traced-back and traced-forward and international alert systems applied. A total of 23 linked point-source outbreaks occurred over the course of one week. Fresh...... green coral lettuce (Lollo Bionda lettuce) had been consumed in all settings. In a cohort study including 234 participants a dish containing green lettuce was associated with illness. Norovirus of Genogroup I (GI) was detected in samples from 28 patients comprising eight of the outbreaks. Sequencing...

Total Economic Consequences of an Influenza Outbreak in the United States.

Science.gov (United States)

Prager, Fynnwin; Wei, Dan; Rose, Adam

2017-01-01

Pandemic influenza represents a serious threat not only to the population of the United States, but also to its economy. In this study, we analyze the total economic consequences of potential influenza outbreaks in the United States for four cases based on the distinctions between disease severity and the presence/absence of vaccinations. The analysis is based on data and parameters on influenza obtained from the Centers for Disease Control and the general literature. A state-of-the-art economic impact modeling approach, computable general equilibrium, is applied to analyze a wide range of potential impacts stemming from the outbreaks. This study examines the economic impacts from changes in medical expenditures and workforce participation, and also takes into consideration different types of avoidance behavior and resilience actions not previously fully studied. Our results indicate that, in the absence of avoidance and resilience effects, a pandemic influenza outbreak could result in a loss in U.S. GDP of $25.4 billion, but that vaccination could reduce the losses to $19.9 billion. When behavioral and resilience factors are taken into account, a pandemic influenza outbreak could result in GDP losses of $45.3 billion without vaccination and $34.4 billion with vaccination. These results indicate the importance of including a broader set of causal factors to achieve more accurate estimates of the total economic impacts of not just pandemic influenza but biothreats in general. The results also highlight a number of actionable items that government policymakers and public health officials can use to help reduce potential economic losses from the outbreaks. © 2016 Society for Risk Analysis.

Shigellosis Outbreak in Al Batinah South Governorate, Oman; Case-control study

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Idris Abaidani

2015-08-01

Full Text Available Objectives: An outbreak of acute gastroenteritis due to Shigella flexneri occurred in August 2012 in the catchment area of the Wadi Sahtan Health Center in Rustaq, Al Batinah South Governorate, Oman. The aim of this study was to discover possible causes of this outbreak in the villages of Fassa, Rogh and Amk and to measure the risk of exposure among cases and controls. Methods: A case-control study was conducted in September 2012 in Fassa, Rogh and Amk. All households in the three villages were interviewed. Case and control households were compared to determine possible exposure avenues, including place of residence, source of drinking water, hand hygiene levels and practices related to drinking water, food preparation and environmental sanitation. Results: Residing in Fassa (P <0.0001; odds ratio [OR] = 4.86, 95% confidence interval [CI] = 2.22–10.63 and average hand hygiene practices (P = 0.008; OR = 13.97, 95% CI = 1.58–123.36 were associated with an increased risk of contracting shigellosis. No significant differences were found with regards to the other exposure avenues. Conclusion: This was the first study conducted in Oman regarding an outbreak of shigellosis in a community setting. The only variables that significantly impacted the risk of acute gastroenteritis were residing in Fassa and average hand hygiene practices. The source of the outbreak could not be identified. However, septic tank sanitation and water and food consumption practices were not satisfactory in the studied villages. These need to be addressed to prevent similar outbreaks of acute gastroenteritis in this region in the future.

Methanol mass poisoning in Iran: role of case finding in outbreak management.

Science.gov (United States)

Hassanian-Moghaddam, Hossein; Nikfarjam, Ali; Mirafzal, Amirhossein; Saberinia, Amin; Nasehi, Abbas Ali; Masoumi Asl, Hossein; Memaryan, Nadereh

2015-06-01

There are no guidelines addressing the public health aspects of methanol poisoning during larger outbreaks. The current study was done to discuss the role of active case finding and a national guideline that organizes all available resources according to a triage strategy in the successful management of a methanol mass poisoning in Rafsanjan, Iran, in May 2013. A retrospective cross-sectional study was performed reviewing the outbreak Emergency Operation Center files. The objectives were to describe the characteristics, management and outcome of a methanol outbreak using Active Case Finding to trace the victims. A total of 694 patients presented to emergency departments in Rafsanjan after public announcement of the outbreak between 29th May and 3rd June 2013. The announcement was mainly performed via short message service (SMS) and local radio broadcasting. A total of 361 cases were observed and managed in Rafsanjan and 333 were transferred to other cities. Seventy-five and 100 patients underwent hemodialysis (HD), retrospectively. The main indication for HD was refractory metabolic acidosis. Eight patients expired due to the intoxication. Except for the deceased cases, no serum methanol level was available. In developing countries, where diagnostic resources are limited, use of active case finding and developing national guidelines can help in the management of large outbreaks of methanol poisonings. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

E. Coli: Preventing Outbreaks at Camp.

Science.gov (United States)

McKinney, Mary D.

1996-01-01

One strain of E. coli is not usually found in foods, but has been related to consumption of undercooked ground beef. Symptoms are stomach cramps and diarrhea, and 2-7% of infections lead to hemolytic uremic syndrome, which is life threatening. Camps can prevent outbreaks by avoiding uncooked meat on overnight campouts and requiring appropriate…

Whole Genome Sequencing for Genomics-Guided Investigations of Escherichia coli O157:H7 Outbreaks.

Science.gov (United States)

Rusconi, Brigida; Sanjar, Fatemeh; Koenig, Sara S K; Mammel, Mark K; Tarr, Phillip I; Eppinger, Mark

2016-01-01

Multi isolate whole genome sequencing (WGS) and typing for outbreak investigations has become a reality in the post-genomics era. We applied this technology to strains from Escherichia coli O157:H7 outbreaks. These include isolates from seven North America outbreaks, as well as multiple isolates from the same patient and from different infected individuals in the same household. Customized high-resolution bioinformatics sequence typing strategies were developed to assess the core genome and mobilome plasticity. Sequence typing was performed using an in-house single nucleotide polymorphism (SNP) discovery and validation pipeline. Discriminatory power becomes of particular importance for the investigation of isolates from outbreaks in which macrogenomic techniques such as pulse-field gel electrophoresis or multiple locus variable number tandem repeat analysis do not differentiate closely related organisms. We also characterized differences in the phage inventory, allowing us to identify plasticity among outbreak strains that is not detectable at the core genome level. Our comprehensive analysis of the mobilome identified multiple plasmids that have not previously been associated with this lineage. Applied phylogenomics approaches provide strong molecular evidence for exceptionally little heterogeneity of strains within outbreaks and demonstrate the value of intra-cluster comparisons, rather than basing the analysis on archetypal reference strains. Next generation sequencing and whole genome typing strategies provide the technological foundation for genomic epidemiology outbreak investigation utilizing its significantly higher sample throughput, cost efficiency, and phylogenetic relatedness accuracy. These phylogenomics approaches have major public health relevance in translating information from the sequence-based survey to support timely and informed countermeasures. Polymorphisms identified in this work offer robust phylogenetic signals that index both short- and

Ground water as the source of an outbreak of Salmonella Enteritidis

Directory of Open Access Journals (Sweden)

Ana Kovačić

2017-09-01

Full Text Available In September 2014, an outbreak of gastroenteritis was reported to the Public Health Institute of Šibenik and Knin County in Croatia. The outbreak occurred in the County center of Šibenik, a town with 50,000 inhabitants, and it lasted for 12 days. An epidemiological investigation suggested a nearby water spring as the source of the outbreak. Due to the temporary closure of the public water supply system, the inhabitants started to use untreated water from a nearby spring. Microbiological analysis revealed that the outbreak was caused by Salmonella enterica subsp. enterica serovar Enteritidis that was isolated from stool samples of the patients and ground water. The isolates were further analysed with pulsed-field gel electrophoresis using XbaI, which revealed an identical macrorestriction profile. Although 68 cases were reported, it was estimated that the actual number of affected persons was more than several hundred. In order to prevent further spread of disease, public advice was released immediately after the first epidemiological indication and a warning sign was placed at the incriminated water source, after microbiological confirmation. It is necessary to regularly monitor microbiological quality of ground water especially in urban areas and provide adequate education and awareness to the inhabitants regarding the risk of using untreated ground water.

[Outbreak of follicular conjunctivitis caused by adenovirus in a geriatric centre].

Science.gov (United States)

Artieda, Juncal; Montes, Milagrosa; Vicente, Diego; Martínez, Consuelo; Piñeiro, Luis; Mendiola, Josune

2010-12-01

Adenovirus serotype 4a is a respiratory virus that occasionally causes conjunctivitis. This paper describes an outbreak of follicular conjunctivitis that occurred in a geriatric centre. Outbreak description and epidemiological research through a survey. For the microbiological study conjunctival swabs were collected using viral and bacterial transport media. Adenovirus was detected by real-time polymerase chain reaction. The serotype was determined by sequencing of a fragment of the hexon and E1 genes. In autumn 2008 an outbreak of follicular conjunctivitis caused by adenovirus serotype 4a was detected. Twenty three percent 23% (69/300) of residents and 5% (9/180) of workers in a geriatric centre in Gipuzkoa were affected. The clinical symptoms were of prolonged duration (11±5 days). The temporal association of the cases suggested transmission from person to person. The sanitary measures established (asepsis and frequent hand washing, cleaning and disinfection of objects and surfaces) were effective, interrupting the transmission of the disease within a short period of time. Rapid detection, identification of the causative agent and implementing appropriate control measures can significantly reduce the impact on both health and economic costs of these outbreaks. Copyright © 2009 Elsevier España, S.L. All rights reserved.

Get the news out loudly and quickly: the influence of the media on limiting emerging infectious disease outbreaks.

Science.gov (United States)

Mummert, Anna; Weiss, Howard

2013-01-01

During outbreaks of infectious diseases with high morbidity and mortality, individuals closely follow media reports of the outbreak. Many will attempt to minimize contacts with other individuals in order to protect themselves from infection and possibly death. This process is called social distancing. Social distancing strategies include restricting socializing and travel, and using barrier protections. We use modeling to show that for short-term outbreaks, social distancing can have a large influence on reducing outbreak morbidity and mortality. In particular, public health agencies working together with the media can significantly reduce the severity of an outbreak by providing timely accounts of new infections and deaths. Our models show that the most effective strategy to reduce infections is to provide this information as early as possible, though providing it well into the course of the outbreak can still have a significant effect. However, our models for long-term outbreaks indicate that reporting historic infection data can result in more infections than with no reporting at all. We examine three types of media influence and we illustrate the media influence with a simulated outbreak of a generic emerging infectious disease in a small city. Social distancing can never be complete; however, for a spectrum of outbreaks, we show that leaving isolation (stopping applying social distancing measures) for up to 4 hours each day has modest effect on the overall morbidity and mortality.

Mixed-genotype white spot syndrome virus infections of shrimp are inversely correlated with disease outbreaks in ponds

NARCIS (Netherlands)

Tuyet Hoa, T.T.; Zwart, M.P.; Phuong, N.T.; Oanh, D.T.H.; Jong, de M.C.M.; Vlak, J.M.

2011-01-01

Outbreaks of white spot syndrome virus (WSSV) in shrimp culture and its relation to virus virulence are not well understood. Here we provide evidence that the presence of WSSV mixed-genotype infections correlate with lower outbreak incidence and that disease outbreaks correlate with single-genotype

Clinical characteristics of acute hepatitis A outbreak in Taiwan, 2015-2016: observations from a tertiary medical center.

Science.gov (United States)

Chen, Nan-Yu; Liu, Zhuo-Hao; Shie, Shian-Sen; Chen, Tsung-Hsing; Wu, Ting-Shu

2017-06-20

Acute hepatitis A is a fecal-oral transmitted disease related to inadequate sanitary conditions. In addition to its traditional classification, several outbreaks in the men who have sex with men (MSM) population have resulted in acute hepatitis A being recognized as a sexually transmitted disease. However, few studies have clarified the clinical manifestations in these outbreaks involving the MSM population. Beginning in June 2015, there was an outbreak of acute hepatitis A involving the MSM population in Northern Taiwan. We conducted a 15-year retrospective study by recruiting 207 patients with the diagnosis of acute hepatitis A that included the pre-outbreak (January 2001 to May 2015) and outbreak (June 2015 to August 2016) periods in a tertiary medical center in Northern Taiwan. Using risk factors, comorbidities, presenting symptoms, laboratory test results and imaging data, we aimed to evaluate the clinical significance of acute hepatitis A in the MSM population, where human immunodeficiency virus (HIV) coinfection is common. There was a higher prevalence of reported MSM (p hepatitis A during the outbreak period. The outbreak population had more prominent systemic symptoms, was more icteric with a higher total bilirubin level (p hepatitis A relapse. The clinical course of acute hepatitis A during an outbreak involving the MSM and HIV-positive population is more symptomatic and protracted than in the general population.

Preparedness of elderly long-term care facilities in HSE East for influenza outbreaks.

LENUS (Irish Health Repository)

O'Connor, L

2015-01-01

Abstract We assessed preparedness of HSE East elderly long-term care facilities for an influenza outbreak, and identified Public Health Department support needs. We surveyed 166 facilities based on the HSE checklist document for influenza outbreaks, with 58% response rate. Client flu vaccination rates were > 75%; leading barriers were client anxiety and consent issues. Target flu vaccine uptake of 40% in staff occurred in 43% of facilities and was associated with staff vaccine administration by afacility-attached GP (p = 0.035), having a facility outbreak plan (p = 0.013) and being anon-HSE run facility (p = 0.013). Leading barriers were staff personal anxiety (94%) and lack of awareness of the protective effect on clients (21%). Eighty-nine percent found Public Health helpful, and requested further educational support and advocacy. Staff vaccine uptake focus, organisational leadership, optimal vaccine provision models, outbreak plans and Public Health support are central to the influenza campaign in elderly long-term care facilities.

Small, round-structured viruses (SRSVs) associated with acute gastroenteritis outbreaks in Gifu, Japan.

Science.gov (United States)

Kawamoto, H; Hasegawa, S; Sawatari, S; Miwa, C; Morita, O; Hosokawa, T; Tanaka, H

1993-01-01

Two outbreaks of non-bacterial gastroenteritis occurred in Gifu prefecture in January 1989 and in January 1991. Both outbreaks were closely related to the consumption of raw oysters, and showed similar clinical features. Small, round-structured virus particles were found in patient stools in both outbreaks by electron microscopy. The role of these particles as the causative agents of the outbreaks were strongly suggested by immune electron microscopy and/or western-blotting immunoassay. When compared with SRSV-9 (Tokyo/SRSV/86-510) reported previously (Hayashi et al, J. Clin. Microbiol., 27: 1728-1733, 1989), it was found that these viral particles were antigenically similar to SRSV-9, and had a major structural protein of 63 kilodaltons (kDa). Further, the prevalence of this agent in Gifu area was examined by western blot antibody assay using 67 serum samples collected from the inhabitants in 1991. The results indicated the circulation of the same or antigenically similar agent in this area.

Social Network Sensors for Early Detection of Contagious Outbreaks

Science.gov (United States)

Christakis, Nicholas A.; Fowler, James H.

2010-01-01

Current methods for the detection of contagious outbreaks give contemporaneous information about the course of an epidemic at best. It is known that individuals near the center of a social network are likely to be infected sooner during the course of an outbreak, on average, than those at the periphery. Unfortunately, mapping a whole network to identify central individuals who might be monitored for infection is typically very difficult. We propose an alternative strategy that does not require ascertainment of global network structure, namely, simply monitoring the friends of randomly selected individuals. Such individuals are known to be more central. To evaluate whether such a friend group could indeed provide early detection, we studied a flu outbreak at Harvard College in late 2009. We followed 744 students who were either members of a group of randomly chosen individuals or a group of their friends. Based on clinical diagnoses, the progression of the epidemic in the friend group occurred 13.9 days (95% C.I. 9.9–16.6) in advance of the randomly chosen group (i.e., the population as a whole). The friend group also showed a significant lead time (pepidemic, a full 46 days before the peak in daily incidence in the population as a whole. This sensor method could provide significant additional time to react to epidemics in small or large populations under surveillance. The amount of lead time will depend on features of the outbreak and the network at hand. The method could in principle be generalized to other biological, psychological, informational, or behavioral contagions that spread in networks. PMID:20856792

Nosocomial outbreak of cryptosporidiosis in AIDS patients

DEFF Research Database (Denmark)

Ravn, Pernille; Lundgren, Jens Dilling; Kjaeldgaard, P

1991-01-01

admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis. MAIN OUTCOME...

Outbreak of Mysterious Illness Among Hospital Staff

DEFF Research Database (Denmark)

Jacobsen, Peter; Ebbehøj, Niels Erik

2016-01-01

BACKGROUND: Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness. CASE REPORT: Four of seven staff members in an emergency...

Attributing human foodborne illness to food sources and water in Latin America and the Caribbean using data from outbreak investigations

DEFF Research Database (Denmark)

Pires, Sara Monteiro; Vieira, Antonio; Perez, Enrique

2012-01-01

&C). Foods implicated in outbreaks were classified by their ingredients as simple foods (i.e. belonging to one single food category), or complex foods (i.e. belonging to multiple food categories). For each agent, the data from simple-food outbreaks were summarized, and the proportion of outbreaks caused...... by each category was used to define the probability that an outbreak was caused by a source. For the calculation of the number of outbreaks attributed to each source, simple-food outbreaks were attributed to the single food category in question, and complex-food outbreaks were partitioned to each category......Foodborne pathogens are responsible for an increasing burden of disease worldwide. Knowledge on the contribution of different food sources and water for disease is essential to prioritize food safety interventions and implement appropriate control measures. Source attribution using outbreak data...

A Systematic Review of Waterborne Disease Outbreaks Associated with Small Non-Community Drinking Water Systems in Canada and the United States.

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Pons, Wendy; Young, Ian; Truong, Jenifer; Jones-Bitton, Andria; McEwen, Scott; Pintar, Katarina; Papadopoulos, Andrew

2015-01-01

Reports of outbreaks in Canada and the United States (U.S.) indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water systems (SDWSs). Summarizing these investigations to identify the factors and conditions contributing to outbreaks is needed in order to help prevent future outbreaks. The objectives of this study were to: 1) identify published reports of waterborne disease outbreaks involving SDWSs in Canada and the U.S. since 1970; 2) summarize reported factors contributing to outbreaks, including water system characteristics and events surrounding the outbreaks; and 3) identify terminology used to describe SDWSs in outbreak reports. Three electronic databases and grey literature sources were searched for outbreak reports involving SDWSs throughout Canada and the U.S. from 1970 to 2014. Two reviewers independently screened and extracted data related to water system characteristics and outbreak events. The data were analyzed descriptively with 'outbreak' as the unit of analysis. From a total of 1,995 citations, we identified 50 relevant articles reporting 293 unique outbreaks. Failure of an existing water treatment system (22.7%) and lack of water treatment (20.2%) were the leading causes of waterborne outbreaks in SDWSs. A seasonal trend was observed with 51% of outbreaks occurring in summer months (pwater source and whether water treatment was used (missing in 31% and 66% of reports, respectively). More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs. Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

A statistical model of the international spread of wild poliovirus in Africa used to predict and prevent outbreaks.

Directory of Open Access Journals (Sweden)

Kathleen M O'Reilly

2011-10-01

Full Text Available Outbreaks of poliomyelitis in African countries that were previously free of wild-type poliovirus cost the Global Polio Eradication Initiative US$850 million during 2003-2009, and have limited the ability of the program to focus on endemic countries. A quantitative understanding of the factors that predict the distribution and timing of outbreaks will enable their prevention and facilitate the completion of global eradication.Children with poliomyelitis in Africa from 1 January 2003 to 31 December 2010 were identified through routine surveillance of cases of acute flaccid paralysis, and separate outbreaks associated with importation of wild-type poliovirus were defined using the genetic relatedness of these viruses in the VP1/2A region. Potential explanatory variables were examined for their association with the number, size, and duration of poliomyelitis outbreaks in 6-mo periods using multivariable regression analysis. The predictive ability of 6-mo-ahead forecasts of poliomyelitis outbreaks in each country based on the regression model was assessed. A total of 142 genetically distinct outbreaks of poliomyelitis were recorded in 25 African countries, resulting in 1-228 cases (median of two cases. The estimated number of people arriving from infected countries and <5-y childhood mortality were independently associated with the number of outbreaks. Immunisation coverage based on the reported vaccination history of children with non-polio acute flaccid paralysis was associated with the duration and size of each outbreak, as well as the number of outbreaks. Six-month-ahead forecasts of the number of outbreaks in a country or region changed over time and had a predictive ability of 82%.Outbreaks of poliomyelitis resulted primarily from continued transmission in Nigeria and the poor immunisation status of populations in neighbouring countries. From 1 January 2010 to 30 June 2011, reduced transmission in Nigeria and increased incidence in reinfected

An Outbreak of Human Fascioliasis gigantica in Southwest China

Science.gov (United States)

Ai, Lin; Xu, Xue-Nian; Jiao, Jian-Ming; Zhu, Ting-Jun; Su, Hui-Yong; Zang, Wei; Luo, Jia-Jun; Guo, Yun-Hai; Lv, Shan; Zhou, Xiao-Nong

2013-01-01

Fascioliasis is a common parasitic disease in livestock in China. However, human fascioliasis is rarely reported in the country. Here we describe an outbreak of human fascioliasis in Yunnan province. We reviewed the complete clinical records of 29 patients and performed an epidemiological investigation on the general human population and animals in the outbreak locality. Our findings support an outbreak due to Fasciola gigantica with a peak in late November, 2011. The most common symptoms were remittent fever, epigastric tenderness, and hepatalgia. Eosinophilia and tunnel-like lesions in ultrasound imaging in the liver were also commonly seen. Significant improvement of patients’ condition was achieved by administration of triclabendazole®. Fasciola spp. were discovered in local cattle (28.6%) and goats (26.0%). Molecular evidence showed a coexistence of F. gigantica and F. hepatica. However, all eggs seen in humans were confirmed to be F. gigantica. Herb (Houttuynia cordata) was most likely the source of infections. Our findings indicate that human fascioliasis is a neglected disease in China. The distribution of triclabendazole®, the only efficacious drug against human fascioliasis, should be promoted. PMID:23951181

Mass media effect on vaccines uptake during silent polio outbreak.

Science.gov (United States)

Sagy, Iftach; Novack, Victor; Gdalevich, Michael; Greenberg, Dan

2018-03-14

During 2013, isolation of a wild type 1 poliovirus from routine sewage sample in Israel, led to a national OPV campaign. During this period, there was a constant cover of the outbreak by the mass media. To investigate the association of media exposure and OPV and non-OPV vaccines uptake during the 2013 silent polio outbreak in Israel. We received data on daily immunization rates during the outbreak period from the Ministry of Health (MoH). We conducted a multivariable time trend analysis to assess the association between daily media exposure and vaccines uptake. Analysis was stratified by ethnicity and socio-economic status (SES). During the MoH supplemental immunization activity, 138,799 OPV vaccines were given. There was a significant association between media exposure and OPV uptake, most prominent in a lag of 3-5 days from the exposure among Jews (R.R 1.79C.I 95% 1.32-2.41) and high SES subgroups (R.R 1.71C.I 95% 1.27-2.30). These subgroups also showed increased non-OPV uptake in a lag of 3-5 days from the media exposure, in all vaccines except for MMR. Lower SES and non-Jewish subgroups did not demonstrate the same association. Our findings expand the understanding of public behaviour during outbreaks. The public response shows high variability within specific subgroups. These findings highlight the importance of tailored communication strategies for each subgroup. Copyright © 2018 Elsevier Ltd. All rights reserved.

Neonatal staphylococcal scalded skin syndrome: clinical and outbreak containment review.

LENUS (Irish Health Repository)

Neylon, Orla

2012-01-31

Staphylococcal scalded skin syndrome (SSSS) is a toxin-mediated exfoliating skin condition predominated by desquamation and blistering. Neonatal outbreaks have already been reported; however, our outbreak highlights the potential for SSSS following neonatal health promotion measures such as intra-muscular vitamin K administration and metabolic screening (heel prick) as well as effective case containment measures and the value of staff screening. Between February and June 2007, five confirmed cases of neonatal SSSS were identified in full-term neonates born in an Irish regional maternity hospital. All infants were treated successfully. Analysis of contact and environmental screening was undertaken, including family members and healthcare workers. Molecular typing on isolates was carried out. An outbreak control team (OCT) was assembled and took successful prospective steps to prevent further cases. All five Staphylococcus aureus isolates tested positive for exfoliative toxin A, of which two distinct strains were identified on pulsed-field gel electrophoresis analysis. Two cases followed staphylococcal inoculation during preventive measures such as intra-muscular vitamin K administration and metabolic screening (heel prick). None of the neonatal isolates were methicillin resistant. Of 259 hospital staff (70% of staff) screened, 30% were colonised with S. aureus, and 6% were positive for MRSA carriage. This is the first reported outbreak of neonatal SSSS in Ireland. Effective case containment measures and clinical value of OCT is demonstrated. Results of staff screening underlines the need for vigilance and compliance in hand disinfection strategies in maternity hospitals especially during neonatal screening and preventive procedures.

Molecular epidemiology of human oral Chagas disease outbreaks in Colombia.

Directory of Open Access Journals (Sweden)

Juan David Ramírez

Full Text Available BACKGROUND: Trypanosoma cruzi, the causative agent of Chagas disease, displays significant genetic variability revealed by six Discrete Typing Units (TcI-TcVI. In this pathology, oral transmission represents an emerging epidemiological scenario where different outbreaks associated to food/beverages consumption have been reported in Argentina, Bolivia, Brazil, Ecuador and Venezuela. In Colombia, six human oral outbreaks have been reported corroborating the importance of this transmission route. Molecular epidemiology of oral outbreaks is barely known observing the incrimination of TcI, TcII, TcIV and TcV genotypes. METHODOLOGY AND PRINCIPAL FINDINGS: High-throughput molecular characterization was conducted performing MLMT (Multilocus Microsatellite Typing and mtMLST (mitochondrial Multilocus Sequence Typing strategies on 50 clones from ten isolates. Results allowed observing the occurrence of TcI, TcIV and mixed infection of distinct TcI genotypes. Thus, a majority of specific mitochondrial haplotypes and allelic multilocus genotypes associated to the sylvatic cycle of transmission were detected in the dataset with the foreseen presence of mitochondrial haplotypes and allelic multilocus genotypes associated to the domestic cycle of transmission. CONCLUSIONS: These findings suggest the incrimination of sylvatic genotypes in the oral outbreaks occurred in Colombia. We observed patterns of super-infection and/or co-infection with a tailored association with the severe forms of myocarditis in the acute phase of the disease. The transmission dynamics of this infection route based on molecular epidemiology evidence was unraveled and the clinical and biological implications are discussed.

Measles outbreak in the Republic of the Marshall Islands, 2003.

Science.gov (United States)

Hyde, Terri B; Dayan, Gustavo H; Langidrik, Justina R; Nandy, Robin; Edwards, Russell; Briand, Kennar; Konelios, Mailynn; Marin, Mona; Nguyen, Huong Q; Khalifah, Anthony P; O'leary, Michael J; Williams, Nobia J; Bellini, William J; Bi, Daoling; Brown, Cedric J; Seward, Jane F; Papania, Mark J

2006-04-01

Measles is a highly contagious viral infection. Measles transmission can be prevented through high population immunity (>or=95%) achieved by measles vaccination. In the Republic of the Marshall Islands (RMI), no measles cases were reported during 1989-2002; however, a large measles outbreak occurred in 2003. Reported 1-dose measles vaccine coverage among children aged 12-23 months varied widely (52-94%) between 1990 and 2000. RMI is a Pacific island nation (1999 population: 50,840). A measles case was defined as fever, rash, and cough, or coryza, or conjunctivitis, in an RMI resident between July 13 and November 7, 2003. A vaccination campaign was used for outbreak control. Of the 826 reported measles cases, 766 (92%) occurred in the capital (Majuro). There were 186 (23%) cases in infants aged or=15 years. The attack rate was highest among infants (Majuro atoll: 213 cases/1,000 infants). Among cases aged 1-14 years, 281 (59%) reported no measles vaccination before July 2003. There were 100 hospitalizations and 3 deaths. The measles H1 genotype was identified. The vaccination campaign resulted in 93% coverage among persons aged 6 months to 40 years. Interpretation Populations without endemic measles transmission can accumulate substantial susceptibility and be at risk for large outbreaks when measles virus is imported. 'Islands' of measles susceptibility may develop in infants, adults, and any groups with low vaccine coverage. To prevent outbreaks, high population immunity must be sustained by maintaining and documenting high vaccine coverage.

Estimating challenge load due to disease outbreaks and other challenges using reproduction records of sows.

Science.gov (United States)

Mathur, P K; Herrero-Medrano, J M; Alexandri, P; Knol, E F; ten Napel, J; Rashidi, H; Mulder, H A

2014-12-01

A method was developed and tested to estimate challenge load due to disease outbreaks and other challenges in sows using reproduction records. The method was based on reproduction records from a farm with known disease outbreaks. It was assumed that the reduction in weekly reproductive output within a farm is proportional to the magnitude of the challenge. As the challenge increases beyond certain threshold, it is manifested as an outbreak. The reproduction records were divided into 3 datasets. The first dataset called the Training dataset consisted of 57,135 reproduction records from 10,901 sows from 1 farm in Canada with several outbreaks of porcine reproductive and respiratory syndrome (PRRS). The known disease status of sows was regressed on the traits number born alive, number of losses as a combination of still birth and mummified piglets, and number of weaned piglets. The regression coefficients from this analysis were then used as weighting factors for derivation of an index measure called challenge load indicator. These weighting factors were derived with i) a two-step approach using residuals or year-week solutions estimated from a previous step, and ii) a single-step approach using the trait values directly. Two types of models were used for each approach: a logistic regression model and a general additive model. The estimates of challenge load indicator were then compared based on their ability to detect PRRS outbreaks in a Test dataset consisting of records from 65,826 sows from 15 farms in the Netherlands. These farms differed from the Canadian farm with respect to PRRS virus strains, severity and frequency of outbreaks. The single-step approach using a general additive model was best and detected 14 out of the 15 outbreaks. This approach was then further validated using the third dataset consisting of reproduction records of 831,855 sows in 431 farms located in different countries in Europe and America. A total of 41 out of 48 outbreaks detected

Pneumonia outbreaks in calves and finishers.

Science.gov (United States)

2016-03-19

Pneumonia in calves and finishers. Ovarian tumour in a calf . Abortion associated with bovine herpesvirus 1 in a suckler herd. Parasitic gastroenteritis causing illthrift and death in sheep. Outbreaks of acute fasciolosis in sheep. These are among matters discussed in the disease surveillance report for December 2015 from SAC Consulting: Veterinary Services (SAC C VS). British Veterinary Association.

Outbreak of Piv-3 in a Neonatal Intensive Care Unit in England.

Science.gov (United States)

Dunn, Gemma Louise; Tapson, Helen; Davis, Jonathan; Gobin, Maya

2017-03-01

An outbreak of PIV-3 in a neonatal ICU was investigated using a retrospective cohort study. Risk of infection increased with lower birth weight and gestational age. Contact with sick visitor(s)/staff was not associated with infection (P = 0.212, P = 0.299). Transmission routes are difficult to identify, and the importance of visiting restrictions and sickness absence during outbreaks is recommended.

A "high severity" spruce beetle outbreak in Wyoming causes moderate-severity carbon cycle perturbations

Science.gov (United States)

Berryman, E.; Frank, J. M.; Speckman, H. N.; Bradford, J. B.; Ryan, M. G.; Massman, W. J.; Hawbaker, T. J.

2017-12-01

Bark beetle outbreaks in Western North American forests are often considered a high-severity disturbance from a carbon (C) cycling perspective, but field measurements that quantify impacts on C dynamics are very limited. Often, factors out of the researcher's control complicate the separation of beetle impacts from other drivers of C cycling variability and restrict statistical inference. Fortuitously, we had four years of pre-spruce beetle outbreak C cycle measurements in a subalpine forest in southeastern Wyoming (Glacier Lakes Ecosystem Experiments Site, or GLEES) and sustained intermittent monitoring for nearly a decade after the outbreak. Here, we synthesize published and unpublished pre- and post-outbreak measurements of key C cycle stocks and fluxes at GLEES. Multiple lines of evidence, including chamber measurements, eddy covariance measurements, and tracking of soil and forest floor C pools over time, point to the GLEES outbreak as a moderate-severity disturbance for C loss to the atmosphere, despite 70% to 80% of overstory tree death. Reductions in NEE were short-lived and the forest quickly returned to a carbon-neutral state, likely driven by an uptick in understory growth. Effect of mortality on the C cycle was asymmetrical, with a 50% reduction in net carbon uptake (NEE) two years into the outbreak, yet no measureable change in either ecosystem or growing season soil respiration. A small pulse in soil respiration occurred but was only detectable during the winter and amounted to < 10% of NEE. Possible reasons for the lack of measureable respiration response are discussed with emphasis on lessons learned for monitoring and modeling future outbreaks. We suggest a comprehensive assessment and definition of "moderate-severity" disturbances for Western forests and suggest that all tree mortality events may not be high-severity when it comes to C fluxes.

Comparative analysis of core genome MLST and SNP typing within a European Salmonella serovar Enteritidis outbreak.