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Kuhn KG, Shukla R, Mannell M, Graves GM, Miller AC, Vogel J, Malloy K, Deshpande G, Florea G, Shelton K, Jeffries E, De León KB, Stevenson B. Using Wastewater Surveillance to Monitor Gastrointestinal Pathogen Infections in the State of Oklahoma. Microorganisms 2023; 11:2193. [PMID: 37764037 PMCID: PMC10536226 DOI: 10.3390/microorganisms11092193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
During the COVID-19 pandemic, wastewater surveillance was widely used to monitor temporal and geographical infection trends. Using this as a foundation, a statewide program for routine wastewater monitoring of gastrointestinal pathogens was established in Oklahoma. The results from 18 months of surveillance showed that wastewater concentrations of Salmonella, Campylobacter, and norovirus exhibit similar seasonal patterns to those observed in reported human cases (F = 4-29, p < 0.05) and that wastewater can serve as an early warning tool for increases in cases, offering between one- and two-weeks lead time. Approximately one third of outbreak alerts in wastewater correlated in time with confirmed outbreaks of Salmonella or Campylobacter and our results further indicated that several outbreaks are likely to go undetected through the traditional surveillance approach currently in place. Better understanding of the true distribution and burden of gastrointestinal infections ultimately facilitates better disease prevention and control and reduces the overall socioeconomic and healthcare related impact of these pathogens. In this respect, wastewater represents a unique opportunity for monitoring infections in real-time, without the need for individual human testing. With increasing demands for sustainable and low-cost disease surveillance, the usefulness of wastewater as a long-term method for tracking infectious disease transmission is likely to become even more pronounced.
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Affiliation(s)
- Katrin Gaardbo Kuhn
- Department of Biostatistics & Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.M.); (G.D.)
| | - Rishabh Shukla
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
| | - Mike Mannell
- Acute Diseases Division, Oklahoma State Department of Health, Oklahoma City, OK 73102, USA;
| | - Grant M. Graves
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
| | - A. Caitlin Miller
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
| | - Jason Vogel
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
| | - Kimberly Malloy
- Department of Biostatistics & Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.M.); (G.D.)
| | - Gargi Deshpande
- Department of Biostatistics & Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.M.); (G.D.)
| | - Gabriel Florea
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
- Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Kristen Shelton
- School of Biological Sciences, University of Oklahoma, Norman, OK 73019, USA; (K.S.); (E.J.); (K.B.D.L.)
| | - Erin Jeffries
- School of Biological Sciences, University of Oklahoma, Norman, OK 73019, USA; (K.S.); (E.J.); (K.B.D.L.)
| | - Kara B. De León
- School of Biological Sciences, University of Oklahoma, Norman, OK 73019, USA; (K.S.); (E.J.); (K.B.D.L.)
| | - Bradley Stevenson
- Department of Earth and Planetary Sciences, Northwestern University, Evanston, IL 60208, USA;
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Israel Y, Muhsen K, Rokney A, Adler A. Epidemiological and Clinical Characteristics of Non-Typhoidal Salmonella Bloodstream Infections in Central Israel: A Case-Control Study. Microorganisms 2022; 10:microorganisms10101942. [PMID: 36296218 PMCID: PMC9608814 DOI: 10.3390/microorganisms10101942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/04/2022] Open
Abstract
Non-typhoidal Salmonella (NTS) infection continues to be a significant cause of morbidity. In addition to gastroenteritis (GE), NTS may cause bloodstream infections (BSI). Our goals were to characterize the demographics, clinical characteristics and outcome of NTS-BSI in central Israel. The study was a retrospective, case-control study conducted at the Tel Aviv Sourasky Medical Center between 2001−2018. Cases with NTS-BSI were matched by age and compared with two control groups, hospitalized patients with NTS-GE and patients with E. coli BSI. The NTS-BSI group included 34 patients who were compared with 69 and 68 patients in the NTS-GE and E. coli BSI groups, respectively. In the NTS-BSI group, the median age was 59 years, with 20% of patients below 20 years of age. Diarrhea was less common in NTS-BSI patients compared with NTS-GE: 53% vs. 80% (p < 0.01). Compared with NTS-GE patients, NTS-BSI patients had a higher rate of recent antimicrobial use: 21% vs. 5.9%, p = 0.03, respectively. They also had a slightly higher Charlson Comorbidity Index score, and history of past malignancy and steroid use, but these differences were not statistically significant. Antimicrobial treatment was documented in 30/34 of the NTS-BSI patients vs. 55/69 of the NTS-GE patients (p < 0.001). NTS-BSI patients had higher rates of in-hospital death (23% vs. 4%, p < 0.01) and a longer length of stay (8 vs. 4 days, p < 0.001) compared with NTS-GE. There was no significant difference in the outcome compared with the E. coli BSI group. In conclusion, our study found relatively low rates of pediatric cases compared with previous studies in Israel. NTS-BSI patients had slightly higher rates of comorbidities compared with NTS-GE patients, and a similar prognosis to E. coli BSI patients.
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Affiliation(s)
- Yael Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
| | - Assaf Rokney
- Public Health Laboratories-Jerusalem (PHL-J), Public Health Services (PHS), Ministry of Health (MOH), Jerusalem 9134302, Israel
| | - Amos Adler
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
- Clinical Microbiology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- Correspondence: ; Tel.: +972-527360780
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Gourishankar A. Geospatial analysis of salmonellosis and its association with socioeconomic status in Texas. Fam Med Community Health 2021; 9:fmch-2021-001214. [PMID: 34625486 PMCID: PMC8504352 DOI: 10.1136/fmch-2021-001214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective The study’s objective was to find the association between salmonellosis and socioeconomic status (SES) in hot spot areas and statewide counties. Design A retrospective cohort study. Setting The data were recorded regarding salmonellosis in 2017 from the Texas surveillance database. It included assessment of hot spot analysis and SES association with salmonellosis at the county level. Participants Patients with salmonellosis of all age groups in Texas. Results There were a total of 5113 salmonellosis from 254 counties with an unadjusted crude rate of 18 per 100 000 person-years. Seven SES risk factors in the hot spot counties were as follows: low values of the severe housing problem, unemployment, African American and high values of social association rate, fast food/full-service restaurant use, Hispanic and Hispanic senior low access-to-store (p<0.05). A 12% difference existed between local health departments in hot (25%) and cold spot (37%) counties (χ2 (1, n=108)=0.5, p=0.81). Statewide independent risk factors were severe housing problem (incidence rate ratio (IRR)=1.1; 95% CI: 1.05 to 1.14), social association rate (IRR=0.89; 95% CI: 0.87 to 0.92), college education (IRR=1.05; 95% CI: 1.04 to 1.07) and non-Hispanic senior local access-to-store (IRR=1.98; 95% CI: 1.26 to 3.11). The severe housing problem predicted zero occurrences of infection in a county (OR=0.51; 95% CI: 0.28 to 0.95). Conclusions Disparity exists in salmonellosis and SES. Attention to unmet needs will decrease salmonellosis. Severe housing problem is a notable risk.
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Affiliation(s)
- Anand Gourishankar
- Division of Pediatric Hospital Medicine, Children's National Hospital, Washington, District of Columbia, USA
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Park MS, Park KH, Bahk GJ. Interrelationships between Multiple Climatic Factors and Incidence of Foodborne Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112482. [PMID: 30405044 PMCID: PMC6266029 DOI: 10.3390/ijerph15112482] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/03/2018] [Accepted: 11/04/2018] [Indexed: 12/26/2022]
Abstract
Climatic factors can affect the incidence of foodborne diseases (FBDs). Moreover, microbial network inference is useful for predicting the interrelationships between the incidence of FBDs and climatic factors. However, the interrelationships between FBD pathogens and most climatic factors are unknown. Using principal component analysis (PCA) and partial correlation coefficient matrices (PCCMs), we determined the intra-ecosystem interrelationship network of the multiple combined effects of 5 climatic factors (temperature, relative humidity, rainfall, insolation, and cloudiness) and the monthly incidences of 12 bacterial FBDs. Many FBD pathogens are interrelated with multiple combined factors. Salmonellosis has strong positive interrelationships with Vibrio parahaemolyticus and enterohemorrhagic Escherichia coli, and the interrelationships between Staphylococcus aureus/enteropathogenic E. coli/enterotoxigenic E. coli exhibits a typical triangular pattern with the combined effects of all 5 climatic factors. Meanwhile, campylobacteriosis and Clostridium perfringens infections are negatively interrelated with insolation and cloudiness. Enteroinvasive E. coli, Bacillus cereus, Listeria spp., and Yersinia enterocolitica are significantly interrelated with any climatic factor combination. The interrelationships or higher-order interrelationships among these climatic factors play an important role in the incidence of FBDs, although the underlying mechanisms remain unclear. Our results will serve as a foundation for more sophisticated models of future FBD patterns with regard to climate change.
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Affiliation(s)
- Myoung Su Park
- Department of Food and Nutrition, Kunsan National University, Gunsan 54150, Jeonbuk, Korea.
| | - Ki Hwan Park
- Department of Food Science and Technology, Chung-Ang University, Ansung 17546, Gyeonggi, Korea.
| | - Gyung Jin Bahk
- Department of Food and Nutrition, Kunsan National University, Gunsan 54150, Jeonbuk, Korea.
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Lal A, Dobbins T, Bagheri N, Baker MG, French NP, Hales S. Cryptosporidiosis Risk in New Zealand Children Under 5 Years Old is Greatest in Areas with High Dairy Cattle Densities. ECOHEALTH 2016; 13:652-660. [PMID: 27766441 DOI: 10.1007/s10393-016-1187-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 09/06/2016] [Accepted: 09/18/2016] [Indexed: 06/06/2023]
Abstract
The public health risks associated with dairy farming intensification are an emerging concern. We examine the association between dairy cattle density and cryptosporidiosis risk in children <5 years old in New Zealand from 1997 to 2008, a period of rapid intensification of the dairy industry. Multi-level Poisson regression was used to model reported cryptosporidiosis (N = 3869 cases) incidence in relation to dairy cattle densities across urban and rural areas separately, after controlling for microbiological quality of public drinking water supplies and neighbourhood socio-economic factors using the Census Area Unit of residence. Within urban areas, the risk of cryptosporidiosis in children less than 5 years old was significantly, positively associated with medium and high dairy cattle density IRR 1.3 (95% CI 1.2, 1.5) and 1.5 (95% CI 1.2, 1.9) respectively, when compared to areas with no dairy cattle. Within rural areas, the incidence risk of cryptosporidiosis in children less than 5 years old were significantly, positively associated with medium and high dairy cattle density: IRR 1.7 (95% CI 1.3, 2.3) and 2.0 (95% CI 1.5, 2.8) respectively, when compared to areas with no dairy cattle. These results have public health implications for children living on and in proximity to intensively stocked dairy cattle farms.
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Affiliation(s)
- Aparna Lal
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Building 62, Acton, Canberra, ACT, 2601, Australia.
| | - Timothy Dobbins
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Building 62, Acton, Canberra, ACT, 2601, Australia
| | - Nasser Bagheri
- Department of Health Service Research and Policy, Research School of Population Health, Australian National University, 63 Eggleston Rd, Canberra, 2601, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago School of Medical and Health Sciences, PO Box 7343, Wellington South, 6242, New Zealand
| | - Nigel P French
- mEpiLab, Hopkirk Research Institute, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand
| | - Simon Hales
- Department of Public Health, University of Otago School of Medical and Health Sciences, PO Box 7343, Wellington South, 6242, New Zealand
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Lal A, Ikeda T, French N, Baker MG, Hales S. Climate variability, weather and enteric disease incidence in New Zealand: time series analysis. PLoS One 2013; 8:e83484. [PMID: 24376707 PMCID: PMC3871872 DOI: 10.1371/journal.pone.0083484] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 11/11/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Evaluating the influence of climate variability on enteric disease incidence may improve our ability to predict how climate change may affect these diseases. OBJECTIVES To examine the associations between regional climate variability and enteric disease incidence in New Zealand. METHODS Associations between monthly climate and enteric diseases (campylobacteriosis, salmonellosis, cryptosporidiosis, giardiasis) were investigated using Seasonal Auto Regressive Integrated Moving Average (SARIMA) models. RESULTS No climatic factors were significantly associated with campylobacteriosis and giardiasis, with similar predictive power for univariate and multivariate models. Cryptosporidiosis was positively associated with average temperature of the previous month (β = 0.130, SE = 0.060, p <0.01) and inversely related to the Southern Oscillation Index (SOI) two months previously (β = -0.008, SE = 0.004, p <0.05). By contrast, salmonellosis was positively associated with temperature (β = 0.110, SE = 0.020, p<0.001) of the current month and SOI of the current (β = 0.005, SE = 0.002, p<0.050) and previous month (β = 0.005, SE = 0.002, p<0.05). Forecasting accuracy of the multivariate models for cryptosporidiosis and salmonellosis were significantly higher. CONCLUSIONS Although spatial heterogeneity in the observed patterns could not be assessed, these results suggest that temporally lagged relationships between climate variables and national communicable disease incidence data can contribute to disease prediction models and early warning systems.
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Affiliation(s)
- Aparna Lal
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Takayoshi Ikeda
- Dean’s Department, University of Otago, Wellington, New Zealand
| | - Nigel French
- Molecular Epidemiology and Public Health laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, New Zealand
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Evaluating area-level spatial clustering of Salmonella Enteritidis infections and their socioeconomic determinants in the greater Toronto area, Ontario, Canada (2007 - 2009): a retrospective population-based ecological study. BMC Public Health 2013; 13:1078. [PMID: 24237666 PMCID: PMC4225613 DOI: 10.1186/1471-2458-13-1078] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 11/13/2013] [Indexed: 12/05/2022] Open
Abstract
Background There have been only a few region-level ecological studies conducted in Canada investigating enteric infections in humans. Our study objectives were to 1) assess the spatial clustering of Salmonella enterica serotype Enteritidis (S. Enteritidis) human infections in the Greater Toronto Area, and 2) identify underlying area-level associations between S. Enteritidis infection rates and socioeconomic status (SES) indicators that might explain the clustering of infections. Methods Retrospective data on S. Enteritidis infections from 2007 to 2009 were obtained from Ontario’s reportable disease surveillance database and were grouped at the forward sortation area (FSA) - level. A spatial scan statistic was employed to identify FSA-level spatial clusters of high infection rates. Negative binomial regression was used to identify FSA-level associations between S. Enteritidis infection rates and SES indicators obtained from the 2006 Census of Canada. Global Moran’s I statistic was used to evaluate the final model for residual spatial clustering. Results A spatial cluster that included nine neighbouring FSAs was identified in downtown Toronto. A significant positive curvilinear relationship was observed between S. Enteritidis infection rates and FSA-level average number of children at home per census family. Areas with high and areas with low average median family income had higher infection rates than FSAs with medium average median family income. Areas with a high proportion of visible minority population had lower infection rates than FSAs with a medium proportion of visible minority population. The Moran’s I statistic was not significant, indicating that no residual spatial autocorrelation was present after accounting for the SES variables in the final model. Conclusions Our study demonstrated that FSAs with high and low average median family income, medium proportion of visible minority population, and high average number of children at home per census family had the highest S. Enteritidis infection rates. These areas should be targeted when designing disease control and prevention programs. Future studies are needed in areas with high S. Enteritidis infection rates to identify sources of environmental contamination of the local food supply, to assess food safety practices at local food markets, retail stores, and restaurants, and to identify novel individual-level risk factors.
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Cheng LH, Crim SM, Cole CR, Shane AL, Henao OL, Mahon BE. Epidemiology of Infant Salmonellosis in the United States, 1996-2008: A Foodborne Diseases Active Surveillance Network Study. J Pediatric Infect Dis Soc 2013; 2:232-9. [PMID: 26619477 DOI: 10.1093/jpids/pit020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 03/07/2013] [Indexed: 11/12/2022]
Abstract
BACKGROUND Infants have increased risk for salmonellosis; but epidemiologic information is limited. METHODS We reviewed Foodborne Diseases Active Surveillance Network reports of laboratory-confirmed non-Typhi Salmonella infections in infants from 1996-2008. We calculated incidence, estimated relative risks, and assessed trends over the duration of the study period, using the first 3 years as reference. RESULTS Average annual incidence of salmonellosis per 100 000 infants was 177.8 (95% confidence interval [CI], 152.7-202.8) in blacks, 129.7 (95% CI, 94.8-164.7) in Asians, and 81.1 (95% CI, 70.2-92.0) in whites. Our analysis of ethnicity independent of race showed salmonellosis incidence of 86.7 (95% CI, 74.6-98.9) in Hispanics and 69.4 (95% CI, 54.8-84.1) in non-Hispanics. Salmonellosis was invasive more often in blacks (9.4%) and Asians (6.4%) than whites (3.6%, P <.001 and P = .01, respectively). Asian infants with salmonellosis were older (median, 31 weeks [range, 0-52]) than black (24 weeks [range, 0-52], P < .001) or white infants (23 weeks [range, 0-52], P < .001). Incidence of all salmonellosis remained stable for whites from 1996-1998 through 2008, but blacks had a sustained decrease, with relative risk of 0.48 (95% CI, .37-.63) in 2008 compared with 1996-1998. However, 2008 incidence remained highest among blacks (141.0 of 100 000 vs 113.5 of 100 000 among whites and 109.9 of 100 000 among Asians). CONCLUSION Black infants had a greater risk of salmonellosis and invasive disease than other racial groups, and despite the greatest decrease in incidence over the study period, they continued to have the highest incidence of salmonellosis. The decrease in salmonellosis in black infants suggests that future improvements may be possible for other population subgroups.
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Affiliation(s)
- Lay Har Cheng
- Pediatric Gastroenterology, Hepatology and Nutrition, Emory University School of Medicine, and
| | - Stacy M Crim
- Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Conrad R Cole
- Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Ohio
| | - Andi L Shane
- Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia
| | - Olga L Henao
- Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Barbara E Mahon
- Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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Varga C, Pearl DL, McEwen SA, Sargeant JM, Pollari F, Guerin MT. Incidence, distribution, seasonality, and demographic risk factors of Salmonella Enteritidis human infections in Ontario, Canada, 2007-2009. BMC Infect Dis 2013; 13:212. [PMID: 23663256 PMCID: PMC3655886 DOI: 10.1186/1471-2334-13-212] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 05/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Canada, surveillance systems have highlighted the increasing trend of Salmonella enterica serovar Enteritidis (S. Enteritidis) human infections. Our study objectives were to evaluate the epidemiology of S. Enteritidis infections in Ontario using surveillance data from January 1, 2007 through December 31, 2009. METHODS Annual age-and-sex-adjusted incidence rates (IRs), annual and mean age-adjusted sex-specific IRs, and mean age-and-sex-adjusted IRs by public health unit (PHU), were calculated for laboratory-confirmed S. Enteritidis cases across Ontario using direct standardization. Multivariable Poisson regression with PHU as a random effect was used to estimate incidence rate ratios (IRRs) of S. Enteritidis infections among years, seasons, age groups, and sexes. RESULTS The annual age-and-sex-adjusted IR per 100,000 person-years was 4.4 [95% CI 4.0-4.7] in 2007, and 5.2 [95% CI 4.8-5.6] in both 2008 and 2009. The annual age-adjusted sex-specific IRs per 100,000 person-years ranged from 4.5 to 5.5 for females and 4.2 to 5.2 for males. The mean age-adjusted sex-specific IR was 5.1 [95% CI 4.8-5.4] for females and 4.8 [95% CI 4.5-5.1] for males. High mean age-and-sex-adjusted IRs (6.001-8.10) were identified in three western PHUs, one northern PHU, and in the City of Toronto. Regression results showed a higher IRR of S. Enteritidis infections in 2009 [IRR = 1.18, 95% CI 1.06-1.32; P = 0.003] and 2008 [IRR = 1.17, 95% CI 1.05-1.31; P = 0.005] compared to 2007. Compared to the fall season, a higher IRR of S. Enteritidis infections was observed in the spring [IRR = 1.14, 95% CI 1.01-1.29; P = 0.040]. Children 0-4 years of age (reference category), followed by children 5-9 years of age [IRR = 0.64, 95% CI 0.52-0.78; P < 0.001] had the highest IRRs. Adults ≥ 60 years of age and 40-49 years of age [IRR = 0.31, 95% CI 0.26-0.37; P < 0.001] had the lowest IRRs. CONCLUSIONS The study findings suggest that there was an increase in the incidence of S. Enteritidis infections in Ontario from 2007 to 2008-2009, and indicate seasonal, demographic, and regional differences, which warrant further public health attention.
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Affiliation(s)
- Csaba Varga
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada
- Ontario Ministry of Agriculture, Food and Rural Affairs, Guelph, ON, N1G 4Y2, Canada
| | - David L Pearl
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Scott A McEwen
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Jan M Sargeant
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada
- Centre for Public Health and Zoonoses, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Frank Pollari
- Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Guelph, ON, N1H 8J1, Canada
| | - Michele T Guerin
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada
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Abstract
SUMMARYThis study describes the epidemiology of human salmonellosis in New Zealand using notified, hospitalized and fatal cases over a 12-year period (1997–2008). The average annual incidence for notifications was 42·8/100 000 population and 3·6/100 000 population for hospitalizations. Incidence was about twice as high in summer as in winter. Rural areas had higher rates than urban areas (rate ratio 1·23, 95% confidence interval 1·22–1·24 for notifications) and a distinct spring peak. Incidence was highest in the 0–4 years age group (154·2 notifications/100 000 and 11·3 hospitalizations/100 000). Hospitalizations showed higher rates for Māori and Pacific Island populations compared to Europeans, and those living in more deprived areas, whereas notifications showed the reverse, implying that notifications are influenced by health-seeking behaviours.SalmonellaTyphimurium was the dominant serotype followed byS. Enteritidis. For a developed country, salmonellosis rates in New Zealand have remained consistently high suggesting more work is needed to investigate, control and prevent this disease.
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Kaneene JB, Miller R, May K, Hattey JA. An Outbreak of Multidrug-ResistantSalmonella entericaSerotype Oranienburg in Michigan Dairy Calves. Foodborne Pathog Dis 2010; 7:1193-201. [DOI: 10.1089/fpd.2010.0551] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- John B. Kaneene
- Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - RoseAnn Miller
- Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Katherine May
- Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Joseph A. Hattey
- Diagnostic Center for Population and Animal Health, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
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Younus M, Wilkins MJ, Davies HD, Rahbar MH, Funk J, Nguyen C, Siddiqi AE, Cho S, Saeed AM. The Role of Exposures to Animals and Other Risk Factors in Sporadic, Non-Typhoidal Salmonella Infections in Michigan Children. Zoonoses Public Health 2010; 57:e170-6. [DOI: 10.1111/j.1863-2378.2010.01324.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Solghan SM, Dumas NB, Root TP, Quinlan TM, Armstrong LR, Spina NL, Zansky SM. Multidrug-Resistant NontyphoidalSalmonellain New York State's Foodborne Diseases Active Surveillance Network Counties. Foodborne Pathog Dis 2010; 7:167-73. [DOI: 10.1089/fpd.2009.0329] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Suzanne M. Solghan
- Emerging Infections Program, New York State Department of Health, Albany, New York
| | - Nellie B. Dumas
- Wadsworth Center Public Health Laboratory, New York State Department of Health, Albany, New York
| | - Timothy P. Root
- Wadsworth Center Public Health Laboratory, New York State Department of Health, Albany, New York
| | - Tammy M. Quinlan
- Wadsworth Center Public Health Laboratory, New York State Department of Health, Albany, New York
| | - Leeanna R. Armstrong
- Wadsworth Center Public Health Laboratory, New York State Department of Health, Albany, New York
| | - Nancy L. Spina
- Emerging Infections Program, New York State Department of Health, Albany, New York
| | - Shelley M. Zansky
- Emerging Infections Program, New York State Department of Health, Albany, New York
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Kaboré H, Michel P, Levallois P, Déry P, Payment P, Lebel G. A descriptive review of selected nonviral enteric illnesses reported in children in Quebec between 1999 and 2006. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2010; 21:e92-8. [PMID: 21629612 PMCID: PMC2912104 DOI: 10.1155/2010/502682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To review the epidemiology of selected nonviral enteric illnesses reported in children in Quebec between 1999 and 2006. METHODS Incidence rates were calculated to describe age, sex, temporal and geographical characteristics of the selected nonviral enteric cases reported in children who were between zero and four years of age. Standard descriptive methods were used to analyze the temporal and geographical distributions of the incidence rates. RESULTS A total of 5068 cases were reported. Of these, three pathogens accounted for the majority of the infections: Giardia (32.52%), Salmonella (30.98%) and Campylobacter (30.82%). Salmonella was most frequent in children younger than one year of age, whereas comparable incidence rates for the three pathogens were calculated for children between one and four years of age. For Giardia, the geographical distributions showed that the highest rates were in areas with more than 100,000 inhabitants (except Montreal, Quebec); for Salmonella, the highest rates were in Montreal; and for Campylobacter, the highest rates were in areas with fewer than 10,000 inhabitants. No detectable trends were seen over the study period for the three pathogens. Seasonal summer peaks were noted for Salmonella and Campylobacter, contrasting with late summer to early autumn peaks for Giardia. CONCLUSION Findings suggest that Giardia, Salmonella and Campylobacter were the most common causes of nonviral enteric illnesses reported in children in Quebec. Giardia cases seemed to arise from different sources and transmission routes than the other two pathogens. Characteristics specific to Campylobacter infections in children, namely its predominance in areas with low population densities, and to Salmonella infections, namely predominance in the Greater Montreal area, should be further investigated to better guide prevention and control measures.
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Affiliation(s)
- Henri Kaboré
- Institut national de santé publique du Québec
- Unité de recherche en santé publique, Centre Hospitalier Universitaire de Québec, Québec
| | - Pascal Michel
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Faculté de Médecine Vétérinaire, Université de Montréal, Montréal
| | - Patrick Levallois
- Institut national de santé publique du Québec
- Unité de recherche en santé publique, Centre Hospitalier Universitaire de Québec, Québec
| | - Pierre Déry
- Département de pédiatrie, Centre hospitalier universitaire de Québec, Québec
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Oloya J, Doetkott D, Khaitsa ML. Antimicrobial drug resistance and molecular characterization of Salmonella isolated from domestic animals, humans, and meat products. Foodborne Pathog Dis 2009; 6:273-84. [PMID: 19341316 DOI: 10.1089/fpd.2008.0134] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES 1) To characterize and determine genotypic relatedness of Salmonella serovars commonly isolated from domestic animals and humans in North Dakota, and 2) to assess their role in transferring antimicrobial resistance (AMR) to humans. MATERIALS AND METHODS A total of 434 Salmonella isolates obtained from 1) feces of apparently healthy feedlot, range, and dairy cattle in North Dakota; 2) clinical samples from sick or dead animals submitted to North Dakota State University-Veterinary Diagnostic Laboratory (2000-2005); 3) previous meat product surveillance studies in North Dakota; and 4) 179 samples from human patients in North Dakota (2000-2005) by the North Dakota Department of Health were studied. The isolates were initially serotyped and later genotyped by pulsed-field gel electrophoresis (PFGE) to investigate their relatedness. The National Antimicrobial Resistance Monitoring Systems panel was used to compare AMR profiles of animal and human isolates to assess a possible role of domestic animals in transfer of AMR to humans. RESULTS Salmonella Typhimurium was the predominant serotype in both humans (13.4%) and domestic animals (34.3%), followed by Newport in animals (2.6%) and human (3.9%). Salmonella Arizona (0.7%), Salmonella Give (0.9%), and Salmonella Muenster (3.5%) were isolated from sick or dead animals. PFGE results confirmed occurrence of similar Salmonella genotypes in both domestic animals and humans. AMR profiles showed that most animal strains were multidrug resistant. A single human isolate had PFGE and multidrug resistance profiles similar to a major cattle genotype, suggesting a possible AMR transmission from cattle to humans. CONCLUSION AND APPLICATION: Similar Salmonella genotypes were infecting domestic animals and humans in North Dakota. The AMR levels were higher in domestic animal isolates than in humans, implying that the occurrence of AMR in animal isolates may not translate directly into AMR in human isolates in North Dakota. This is helpful in determining future policies regarding antimicrobial drug use in domestic animals and humans.
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Affiliation(s)
- J Oloya
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, USA
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An ecological analysis of sociodemographic factors associated with the incidence of salmonellosis, shigellosis, and E. coli O157:H7 infections in US counties. Epidemiol Infect 2008; 137:810-20. [PMID: 18947443 DOI: 10.1017/s0950268808001477] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Identifying county-level sociodemographic and economic factors associated with the incidence of enteric disease may provide new insights concerning the dynamics of community transmission of these diseases as well as opportunities for prevention. We used data from the National Notifiable Diseases Surveillance System, the U.S. Census Bureau, and the Health Resources and Services Administration to conduct an ecological analysis of 26 sociodemographic and economic factors associated with the incidence of salmonellosis, shigellosis, and E. coli O157:H7 infections in US counties for the period 1993 to 2002. Our study indicates that race, ethnicity, place of residence, age, educational attainment, and poverty may affect the risk of acquiring one of these enteric bacterial diseases. The lack of specificity of information regarding salmonellae and shigellae serotypes may have led to less specific associations between community-level determinants and reported incidence of those diseases. Future ecological analyses should use serotype-specific data on incidence, which may be available from laboratory-based surveillance systems.
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Arshad MM, Wilkins MJ, Downes FP, Rahbar MH, Erskine RJ, Boulton ML, Younus M, Saeed AM. Epidemiologic attributes of invasive non-typhoidal Salmonella infections in Michigan, 1995–2001. Int J Infect Dis 2008; 12:176-82. [PMID: 17889584 DOI: 10.1016/j.ijid.2007.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Revised: 06/13/2007] [Accepted: 06/20/2007] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES To determine: (1) the incidence of invasive salmonellosis, (2) the distribution of specific Salmonella serotypes associated with invasive disease, and (3) the role of demographic characteristics in invasive salmonellosis in Michigan. DESIGN We conducted a cross-sectional study using laboratory-confirmed cases of salmonellosis reported to the Michigan Department of Community Health between 1995 and 2001. METHODS Average annual incidences (AAIs) for invasive salmonellosis were computed, and Poisson regression analysis was used to model the association between demographic attributes and invasive salmonellosis. RESULTS Of 6797 cases of salmonellosis, 347 (5.1%) were characterized as invasive having an AAI of 0.5/100000. A covariate-adjusted Poisson model showed children aged <1 year to be at higher risk for invasive salmonellosis compared to adults aged 40-49 years (rate ratio (RR) 8.98, 95% confidence interval (CI) 5.69-14.17). No significant differences were found between males and females (RR 1.02, 95% CI 0.83-1.26), African-Americans and Caucasians (RR 0.95, 95% CI 0.64-1.42), and urban and rural residents (RR 0.98, 95% CI 0.76-1.26). Among the most common serotypes associated with invasive salmonellosis (Heidelberg, Typhimurium, and Enteritidis), Salmonella serotype Heidelberg had the highest blood invasiveness ratio (15.79/100). CONCLUSIONS Children aged <1 year, especially of minority groups, are at higher risk for invasive Salmonella infections. Invasive salmonellosis may be included in the differential diagnosis of acute bacterial infections in young children with positive stool cultures for Salmonella.
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Affiliation(s)
- M Mokhtar Arshad
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
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Oloya J, Theis M, Doetkott D, Dyer N, Gibbs P, Khaitsa ML. Evaluation of Salmonella occurrence in domestic animals and humans in North Dakota (2000-2005). Foodborne Pathog Dis 2008; 4:551-63. [PMID: 18041964 DOI: 10.1089/fpd.2007.0014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES To evaluate the occurrence, serotypes, and antimicrobial susceptibility of Salmonellae from domestic animals and humans in North Dakota. MATERIALS AND METHODS Salmonellosis data (2000-2005) in humans (n = 286) and animals (n = 258) were extracted from the North Dakota Department of Health (NDDoH) and North Dakota State University Veterinary Diagnostic Laboratory (NDSU-VDL), and analyzed for temporal and spatial trends, and for other associations. Additionally, random samples of 35, 30, and 15 Salmonella isolates from NDSU-VDL, NDDoH, and North Dakota healthy cattle, respectively, were tested for antimicrobial susceptibility. RESULTS Most animal salmonellosis occurred in cattle (64.7%) sheep (12%), pigs (10.9%), and bison (0.4%) with Salmonella Typhimurium (45.7%) as the predominant serotype; Salmonella Arizona (10.9%) and Dublin (10.5%) were host specific in sheep and cattle respectively. In humans, Salmonella Typhimurium (32.5%) and Salmonella Newport (11.2%) were predominant. Season influenced human (p = 0.027) and animal (p = 0.014) salmonellosis with cases peaking in the spring and summer for animals and humans, respectively. Salmonella Typhimurium case reports in humans were not seasonally related to domestic animals (p = 0.001) nor cattle (p = 0.001). Over time, case reports increased in humans but decreased in domestic animals. Most serotypes from domestic animals were multidrug resistant compared to human isolates. CONCLUSIONS AND APPLICATIONS: Many Salmonella serotypes (17) were involved in North Dakota human and animal salmonellosis with case reports closely related in fall and winter, but not during warmer months. Spatial clustering of human and animal cases was similar. Antimicrobial resistance was widespread but lower in human isolates. These data are helpful in determining future policy, research, and control strategies for salmonellosis in humans and domestic animals.
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Affiliation(s)
- J Oloya
- Department of Veterinary and Microbiological Sciences, North Dakota State University, Fargo, North Dakota
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Younus M, Hartwick E, Siddiqi AA, Wilkins M, Davies HD, Rahbar M, Funk J, Saeed M. The role of neighborhood level socioeconomic characteristics in Salmonella infections in Michigan (1997-2007): assessment using geographic information system. Int J Health Geogr 2007; 6:56. [PMID: 18093323 PMCID: PMC2267442 DOI: 10.1186/1476-072x-6-56] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Accepted: 12/19/2007] [Indexed: 11/10/2022] Open
Abstract
Background: The majority of U.S. disease surveillance systems contain incomplete information regarding socioeconomic status (SES) indicators like household or family income and educational attainment in case reports, which reduces the usefulness of surveillance data for these parameters. We investigated the association between select SES attributes at the neighborhood level and Salmonella infections in the three most populated counties in Michigan using a geographic information system. Methods: We obtained data on income, education, and race from the 2000 U.S. Census, and the aggregate number of laboratory-confirmed cases of salmonellosis (1997–2006) at the block group level from the Michigan Department of Community Health. We used ArcGIS to visualize the distribution, and Poisson regression analysis to study associations between potential predictor variables and Salmonella infections. Results: Based on data from 3,419 block groups, our final multivariate model revealed that block groups with lower educational attainment were less commonly represented among cases than their counterparts with higher education levels (< high school degree vs. ≥ college degree: rate ratio (RR) = 0.79, 95% confidence interval (CI):0.63, 0.99; ≥ and high school degree, but no college degree vs. ≥ college degree: RR = 0.84, 95% CI: 0.76, 0.92). Levels of education also showed a dose-response relation with the outcome variable, i.e., decreasing years of education was associated with a decrease in Salmonella infections incidence at the block group level. Conclusion: Education plays a significant role in health-seeking behavior at the population level. It is conceivable that a reporting bias may exist due to a greater detection of Salmonella infections among high education block groups compared to low education block groups resulting from differential access to healthcare. In addition, individuals of higher education block groups who also have greater discretionary income may eat outside the home frequently and be more likely to own pets considered reservoirs of Salmonella, which increase the likelihood of contracting Salmonella infections compared to their counterparts with lower levels of education. Public health authorities should focus on improving the level of disease detection and reporting among communities with lower income and education and further evaluate the role of higher educational attainment in the predisposition for salmonellosis.
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Affiliation(s)
- Muhammad Younus
- Department of Epidemiology, Michigan State University, East Lansing, Michigan 48824, USA.
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