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Tunstall AM, O'Brien SC, Monaghan DM, Burakoff A, Marquardt RK. Lessons Learned from Cross-Systems Approach to COVID-19 Pandemic Response in Juvenile Justice System, Colorado, USA. Emerg Infect Dis 2024; 30:S13-S16. [PMID: 38561629 PMCID: PMC10986830 DOI: 10.3201/eid3013.230782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
The global COVID-19 pandemic illustrates the importance of a close partnership between public health and juvenile justice systems when responding to communicable diseases. Many setting-specific obstacles must be navigated to respond effectively to limit disease transmission and negative health outcomes while maintaining necessary services for youth in confinement facilities. The response requires multidisciplinary expertise and collaboration to address unique considerations. Public health mitigation strategies must balance the risk for disease against the negative effects of restrictions. Key aspects of the COVID-19 response in the juvenile justice system of Colorado, USA, involved establishing robust communication and data reporting infrastructures, building a multidisciplinary response team, adapting existing infection prevention guidelines, and focusing on a whole-person health approach to infection prevention. We examine lessons learned and offer recommendations on pandemic emergency response planning and managing a statewide public health emergency in youth confinement settings that ensure ongoing readiness.
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Martinez HE, Marshall KE, Showell VW, Tate JE, Kirking HL, Broudy M, Matzinger SR, Burakoff A, Deng L, Payne DC, Fleming-Dutra K, Jervis RH. Evaluation of Correctional Facility COVID-19 Outbreaks With Layered Mitigation Strategies Including Vaccination: Colorado, 2020-2021. J Correct Health Care 2023. [PMID: 36989514 DOI: 10.1089/jchc.21.12.0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
In 2020-2021, a Colorado corrections facility experienced four COVID-19 outbreaks. Case counts, attack rates (ARs) in people who are detained or incarcerated (PDI), and mitigation measures used in each outbreak were compared to evaluate effects of combined strategies. Serial PCR testing, isolation/quarantine, and masking were implemented in outbreak 1. Daily staff antigen testing began in outbreak 2. Facility-wide COVID-19 vaccination started in outbreak 3 and coverage increased by the end of outbreak 4 (PDI: <1% to 59%, staff: 27% to 40%). Despite detection of variants of concern, outbreaks 3 and 4 had 97% lower PDI ARs (both 1%) than outbreak 2 (29%). Daily staff testing and increasing vaccination coverage, with other outbreak mitigation strategies, are important to reduce COVID-19 transmission in congregate settings.
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Affiliation(s)
- Heather E Martinez
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
- Council of State and Territorial Epidemiologists, Atlanta, Georgia, USA
| | - Kristen E Marshall
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
- Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia, USA
| | - Velton W Showell
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - Jacqueline E Tate
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia, USA
| | - Hannah L Kirking
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia, USA
| | - Melissa Broudy
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | | | - Alexis Burakoff
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - Li Deng
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia, USA
| | - Daniel C Payne
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia, USA
| | | | - Rachel H Jervis
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
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O'Brien SC, Cole LD, Albanese BA, Mahon A, Knight V, Williams N, Severson R, Burakoff A, Alden NB, Dominguez SR. SARS-CoV-2 Seroprevalence Compared with Confirmed COVID-19 Cases among Children, Colorado, USA, May-July 2021. Emerg Infect Dis 2023; 29:929-936. [PMID: 36972709 PMCID: PMC10124638 DOI: 10.3201/eid2905.221541] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
To compare SARS-CoV-2 antibody seroprevalence among children with seropositive confirmed COVID-19 case counts (case ascertainment by molecular amplification) in Colorado, USA, we conducted a cross-sectional serosurvey during May-July 2021. For a convenience sample of 829 Colorado children, SARS-CoV-2 seroprevalence was 36.7%, compared with prevalence of 6.5% according to individually matched COVID-19 test results reported to public health. Compared with non-Hispanic White children, seroprevalence was higher among Hispanic, non-Hispanic Black, and non-Hispanic other race children, and case ascertainment was significantly lower among Hispanic and non-Hispanic Black children. This serosurvey accurately estimated SARS-CoV-2 prevalence among children compared with confirmed COVID-19 case counts and revealed substantial racial/ethnic disparities in infections and case ascertainment. Continued efforts to address racial and ethnic differences in disease burden and to overcome potential barriers to case ascertainment, including access to testing, may help mitigate these ongoing disparities.
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Pastula DM, Copeland MJ, Hannan MC, Rapaka S, Kitani T, Kleiner E, Showler A, Yuen C, Ferriman EM, House J, O’Brien S, Burakoff A, Gupta B, Money KM, Matthews E, Beckham JD, Chauhan L, Piquet AL, Kumar RN, Tornatore CS, Padgett K, O’Laughlin K, Mangla AT, Kumar PN, Tyler KL, O’Connor SM. Two Cases of Monkeypox-Associated Encephalomyelitis — Colorado and the District of Columbia, July–August 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1212-1215. [PMID: 36136957 PMCID: PMC9531567 DOI: 10.15585/mmwr.mm7138e1] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Metz AR, Bauer M, Epperly C, Stringer G, Marshall KE, Webb LM, Hetherington-Rauth M, Matzinger SR, Totten SE, Travanty EA, Good KM, Burakoff A. Investigation of COVID-19 Outbreak among Wildland Firefighters during Wildfire Response, Colorado, USA, 2020. Emerg Infect Dis 2022; 28:1551-1558. [PMID: 35705189 PMCID: PMC9328929 DOI: 10.3201/eid2808.220310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A COVID-19 outbreak occurred among Cameron Peak Fire responders in Colorado, USA, during August 2020–January 2021. The Cameron Peak Fire was the largest recorded wildfire in Colorado history, lasting August–December 2020. At least 6,123 responders were involved, including 1,260 firefighters in 63 crews who mobilized to the fire camps. A total of 79 COVID-19 cases were identified among responders, and 273 close contacts were quarantined. State and local public health investigated the outbreak and coordinated with wildfire management teams to prevent disease spread. We performed whole-genome sequencing and applied social network analysis to visualize clusters and transmission dynamics. Phylogenetic analysis identified 8 lineages among sequenced specimens, implying multiple introductions. Social network analysis identified spread between and within crews. Strategies such as implementing symptom screening and testing of arriving responders, educating responders about overlapping symptoms of smoke inhalation and COVID-19, improving physical distancing of crews, and encouraging vaccinations are recommended.
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Herlihy R, Bamberg W, Burakoff A, Alden N, Severson R, Bush E, Kawasaki B, Berger B, Austin E, Shea M, Gabrieloff E, Matzinger S, Burdorf A, Nichols J, Goode K, Cilwick A, Stacy C, Staples E, Stringer G. Rapid Increase in Circulation of the SARS-CoV-2 B.1.617.2 (Delta) Variant - Mesa County, Colorado, April-June 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1084-1087. [PMID: 34383734 PMCID: PMC8360276 DOI: 10.15585/mmwr.mm7032e2] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hagan LM, Williams SP, Spaulding AC, Toblin RL, Figlenski J, Ocampo J, Ross T, Bauer H, Hutchinson J, Lucas KD, Zahn M, Chiang C, Collins T, Burakoff A, Bettridge J, Stringer G, Maul R, Waters K, Dewart C, Clayton J, de Fijter S, Sadacharan R, Garcia L, Lockett N, Short K, Sunder L, Handanagic S. Mass Testing for SARS-CoV-2 in 16 Prisons and Jails - Six Jurisdictions, United States, April-May 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1139-1143. [PMID: 32817597 PMCID: PMC7439979 DOI: 10.15585/mmwr.mm6933a3] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Messacar K, Spence-Davizon E, Osborne C, Press C, Schreiner TL, Martin J, Messer R, Maloney J, Burakoff A, Barnes M, Rogers S, Lopez AS, Routh J, Gerber SI, Oberste MS, Nix WA, Abzug MJ, Tyler KL, Herlihy R, Dominguez SR. Clinical characteristics of enterovirus A71 neurological disease during an outbreak in children in Colorado, USA, in 2018: an observational cohort study. Lancet Infect Dis 2019; 20:230-239. [PMID: 31859216 DOI: 10.1016/s1473-3099(19)30632-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/15/2019] [Accepted: 10/22/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND In May, 2018, Children's Hospital Colorado noted an outbreak of enterovirus A71 (EV-A71) neurological disease. We aimed to characterise the clinical features of EV-A71 neurological disease during this outbreak. METHODS In this retrospective observational cohort study, children (younger than 18 years) who presented to Children's Hospital Colorado (Aurora, CO, USA) between March 1 and November 30, 2018, with neurological disease (defined by non-mutually exclusive criteria, including meningitis, encephalitis, acute flaccid myelitis, and seizures) and enterovirus detected from any biological specimen were eligible for study inclusion. The clinical characteristics of children with neurological disease associated with EV-A71 were compared with those of children with neurological disease associated with other enteroviruses during the same period. To explore the differences in clinical presentation of acute flaccid myelitis, we also used a subgroup analysis to compare clinical findings in children with EV-A71-associated acute flaccid myelitis during the study period with these findings in those with enterovirus D68 (EV-D68)-associated acute flaccid myelitis at the same hospital between 2013 and 2018. FINDINGS Between March 10 and Nov 10, 2018, 74 children presenting to Children's Hospital Colorado were found to have enterovirus neurological disease; EV-A71 was identified in 43 (58%) of these children. The median age of the children with EV-A71 neurological disease was 22·7 months (IQR 4·0-31·9), and most of these children were male (34 [79%] children). 40 (93%) children with EV-A71 neurological disease had findings suggestive of meningitis, 31 (72%) children showed evidence of encephalitis, and ten (23%) children met our case definition of acute flaccid myelitis. All children with EV-A71 disease had fever and 18 (42%) children had hand, foot, or mouth lesions at or before neurological onset. Children with EV-A71 disease were best differentiated from those with other enteroviruses (n=31) by the neurological findings of myoclonus, ataxia, weakness, and autonomic instability. Of the specimens collected from children with EV-A71, this enterovirus was detected in 94% of rectal, 79% of oropharyngeal, 56% of nasopharyngeal, and 20% of cerebrospinal fluid specimens. 39 (93%) of 42 children with EV-A71 neurological disease who could be followed up showed complete recovery by 1-2 months. Compared with children with EV-D68-associated acute flaccid myelitis, children with EV-A71-associated acute flaccid myelitis were younger, showed neurological onset earlier after prodromal symptom onset, had milder weakness, showed more rapid improvement, and were more likely to completely recover. INTERPRETATION This outbreak of EV-A71 neurological disease, the largest reported in the Americas, was characterised by fever, myoclonus, ataxia, weakness, autonomic instability, and full recovery in most patients. Because EV-A71 epidemiology outside of Asia remains difficult to predict, identification of future outbreaks will be aided by prompt recognition of these distinct clinical findings, testing of non-sterile and sterile site specimens, and enhanced enterovirus surveillance. FUNDING None.
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Affiliation(s)
- Kevin Messacar
- Section of Infectious Diseases, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA.
| | | | - Christina Osborne
- Section of Infectious Diseases, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA
| | - Craig Press
- Section of Child Neurology, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA
| | - Teri L Schreiner
- Section of Child Neurology, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA
| | - Jan Martin
- Section of Child Neurology, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA
| | - Ricka Messer
- Section of Child Neurology, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA
| | - John Maloney
- Section of Radiology, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA
| | - Alexis Burakoff
- Colorado Department of Public Health and the Environment, Denver, CO, USA; Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Meghan Barnes
- Colorado Department of Public Health and the Environment, Denver, CO, USA
| | - Shannon Rogers
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adriana S Lopez
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Janell Routh
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susan I Gerber
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - W Allan Nix
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark J Abzug
- Section of Infectious Diseases, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA
| | - Kenneth L Tyler
- Department of Pediatrics and Department of Neurology, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Rachel Herlihy
- Colorado Department of Public Health and the Environment, Denver, CO, USA
| | - Samuel R Dominguez
- Section of Infectious Diseases, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA
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Idubor O, Alden NB, Nanduri S, Ogundimu A, Tanwar SSS, Reese H, Odongo W, Herlihy R, Johnston H, Burakoff A, Burdorf A, Dale AP, Nichols J, Bamberg WM, Cilwick A, Barter D, Brousseau G, Chochua S, Stone ND, Van Beneden C. 1891. Invasive Group A Streptococcus Infections Among Residents of Multiple Nursing Homes—Denver, Colorado, 2017–2018. Open Forum Infect Dis 2019. [PMCID: PMC6809078 DOI: 10.1093/ofid/ofz359.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Older adults residing in nursing homes (NH) are at increased risk for invasive group A Streptococcus (GAS) infections due to advanced age, presence of wounds, and comorbidities; approximately one-third of infected patients die. Beginning in 2015, increasing numbers of GAS infections in NH residents and several NH clusters were reported from the Denver metropolitan area. Colorado Department of Public Health and Environment (CDPHE) and CDC investigated to characterize cases and assess if outbreaks resulted from interfacility transmission. Methods We reviewed data from Active Bacterial Core surveillance (ABCs) in the 5-county Denver area from January 2017 to June 2018. We defined a case as isolation of GAS from a normally sterile site in an NH resident. GAS isolates underwent whole-genome sequencing (WGS) at CDC’s Streptococcus Laboratory to determine emm types for genotyping. Among isolates with the same emm type, pairwise single-nucleotide polymorphism (SNP) distances were calculated using Nucmer software. In October 2018, a CDPHE-CDC team assessed infection control at NHs with cases of the most common emm type. Results Over 18 months, among >100 NHs in the Denver area, ≥1 GAS case was identified in 29 NHs, with 6 having ≥3 cases. During this period, 68 cases in NH residents were identified. WGS identified 17 emm types among isolates from these cases; most common was emm11.10 (34%, n = 22), a rare subtype in ABCs. All emm11.10 isolates had nearly identical genomes (average pairwise SNP distance: 3.2), and were isolated from 10 NHs, with 2 NHs having ≥ 4 cases. Multiple infection control lapses were noted during site visits to 8 NHs. Conclusion Multiple outbreaks due to GAS were noted in 5-county Denver area NHs in 2017–2018. WGS of surveillance isolates identified a rarely seen emm subtype 11.10 from multiple facilities with temporal and genomic clustering suggesting interfacility GAS transmission. ![]()
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Disclosures All Authors: No reported Disclosures.
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Affiliation(s)
| | - Nisha B Alden
- Colorado Department of Public Health and Environment, Denver, Colorado
| | | | | | | | - Heather Reese
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wycliffe Odongo
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rachel Herlihy
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Helen Johnston
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Alexis Burakoff
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - April Burdorf
- Colorado Department of Public Health and Environment, Denver, Colorado
| | | | - Janell Nichols
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Wendy M Bamberg
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Alana Cilwick
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Devra Barter
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Geoff Brousseau
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Sopio Chochua
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nimalie D Stone
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Tobolowsky F, Burakoff A, House J, Marzec N, Neumeier A, Sparks P, McLees M. Notes from the Field: Hantavirus Pulmonary Syndrome - Denver, Colorado, 2018. MMWR Morb Mortal Wkly Rep 2019; 68:771-772. [PMID: 31487276 DOI: 10.15585/mmwr.mm6835a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Messacar K, Burakoff A, Nix WA, Rogers S, Lopez AS, Oberste MS, Gerber SI, Spence-Davizon E, Herlihy R, Dominguez S. LB8. Outbreak of Enterovirus A71 Neurologic Disease in Children—Colorado, 2018. Open Forum Infect Dis 2018. [PMCID: PMC6253202 DOI: 10.1093/ofid/ofy229.2182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Methods Results Conclusion Disclosures
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Affiliation(s)
- Kevin Messacar
- Pediatric Infectious Diseases and Hospital Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado
| | - Alexis Burakoff
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William A Nix
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, Atlanta, Georgia
| | - Shannon Rogers
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adriana S Lopez
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - M Steve Oberste
- Polio and Picornavirus Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Rachel Herlihy
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Samuel Dominguez
- Pediatrics, University of Colorado and The Children’s Hospital, Aurora, Colorado
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Robertson S, Burakoff A, Stevenson L, Tompkins B, Patel K, Tolar B, Whitlock L, House J, Schlater L, Mackie T, Morningstar-Shaw B, Nichols M, Basler C. Notes from the Field: Recurrence of a Multistate Outbreak of Salmonella Enteritidis Infections Linked to Contact with Guinea Pigs - Eight States, 2015-2017. MMWR Morb Mortal Wkly Rep 2018; 67:1195-1196. [PMID: 30359346 PMCID: PMC6290818 DOI: 10.15585/mmwr.mm6742a6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Marx GE, Burakoff A, Barnes M, Hite D, Metz A, Miller K, Davizon ES, Chase J, McDonald C, McClean M, Miller L, Albanese BA. Mumps Outbreak in a Marshallese Community - Denver Metropolitan Area, Colorado, 2016-2017. MMWR Morb Mortal Wkly Rep 2018; 67:1143-1146. [PMID: 30335736 PMCID: PMC6193691 DOI: 10.15585/mmwr.mm6741a2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Messacar K, Burakoff A, Nix WA, Rogers S, Oberste MS, Gerber SI, Spence-Davizon E, Herlihy R, Dominguez SR. Notes from the Field: Enterovirus A71 Neurologic Disease in Children - Colorado, 2018. MMWR Morb Mortal Wkly Rep 2018; 67:1017-1018. [PMID: 30212441 PMCID: PMC6146947 DOI: 10.15585/mmwr.mm6736a5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Burakoff A, Brown K, Knutsen J, Hopewell C, Rowe S, Bennett C, Cronquist A. Outbreak of Fluoroquinolone-Resistant Campylobacter jejuni Infections Associated with Raw Milk Consumption from a Herdshare Dairy - Colorado, 2016. MMWR Morb Mortal Wkly Rep 2018; 67:146-148. [PMID: 29420460 PMCID: PMC5812469 DOI: 10.15585/mmwr.mm6705a2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
In August 2016, a local public health agency (LPHA) notified the Colorado Department of Public Health and Environment (CDPHE) of two culture-confirmed cases of Campylobacter infection among persons who consumed raw (unpasteurized) milk from the same herdshare dairy. In Colorado, the sale of raw milk is illegal; however, herdshare programs, in which a member can purchase a share of a herd of cows or goats, are legal and are not regulated by state or local authorities. In coordination with LPHAs, CDPHE conducted an outbreak investigation that identified 12 confirmed and five probable cases of Campylobacter jejuni infection. Pulsed-field gel electrophoresis (PFGE) patterns for the 10 cases with available isolates were identical using the enzyme Sma. In addition, two milk samples (one from the dairy and one obtained from an ill shareholder) also tested positive for the outbreak strain. Five C. jejuni isolates sent to CDC for antimicrobial susceptibility testing were resistant to ciprofloxacin, tetracycline, and nalidixic acid (1). Although shareholders were notified of the outbreak and cautioned against drinking the milk on multiple occasions, milk distribution was not discontinued. Although its distribution is legal through herdshare programs, drinking raw milk is inherently risky (2). The role of public health in implementing control measures associated with a product that is known to be unsafe remains undefined.
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Burakoff A, Lehman J, Fischer M, Staples JE, Lindsey NP. West Nile Virus and Other Nationally Notifiable Arboviral Diseases - United States, 2016. MMWR Morb Mortal Wkly Rep 2018; 67:13-17. [PMID: 29324725 PMCID: PMC5769797 DOI: 10.15585/mmwr.mm6701a3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the continental United States (1,2). Other arboviruses, including La Crosse, Powassan, Jamestown Canyon, St. Louis encephalitis, and eastern equine encephalitis viruses, cause sporadic cases of disease and occasional outbreaks. This report summarizes surveillance data reported to CDC for 2016 for nationally notifiable arboviruses. It excludes dengue, chikungunya, and Zika viruses, as these are primarily nondomestic viruses typically acquired through travel. Forty-seven states and the District of Columbia (DC) reported 2,240 cases of domestic arboviral disease, including 2,150 (96%) WNV disease cases. Of the WNV disease cases, 1,310 (61%) were classified as neuroinvasive disease (e.g., meningitis, encephalitis, acute flaccid paralysis), for a national incidence of 0.41 cases per 100,000 population. After WNV, the most frequently reported arboviruses were La Crosse (35 cases), Powassan (22), and Jamestown Canyon (15) viruses. Because arboviral diseases continue to cause serious illness, maintaining surveillance is important to direct prevention activities.
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Sobotova L, Liu YH, Burakoff A, Sevcikova L, Weitzman M. Household exposure to secondhand smoke is associated with decreased physical and mental health of mothers in the USA. Matern Child Health J 2011; 15:128-37. [PMID: 20012677 DOI: 10.1007/s10995-009-0549-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Secondhand smoke is one of the most common toxic environmental exposures to children, and maternal health problems also have substantial negative effects on children. We are unaware of any studies examining the association of living with smokers and maternal health. To investigate whether non-smoking mothers who live with smokers have worse physical and mental health than non-smoking mothers who live in homes without smokers. Nationally representative data from the 2000-2004 Medical Expenditure Panel Survey were used. The health of non-smoking mothers with children <18 years (n = 18,810) was assessed, comparing those living with one or more smokers (n = 3,344) to those living in households with no adult smokers (n = 14,836). Associations between maternal health, household smoking, and maternal age, race/ethnicity, and marital, educational, poverty and employment status were examined in bivariable and multivariable analyses using SUDAAN software to adjust for the complex sampling design. Scores on the Medical Outcomes Short Form-12 (SF-12) Physical Component Scale (PCS) and Mental Component Scale (MCS) were used to assess maternal health. About 79.2% of mothers in the USA are non-smokers and 17.4% of them live with ≥1 adult smokers: 14.2% with 1 and 3.2% with ≥2 smokers. Among non-smoking mothers, the mean MCS score is 50.5 and mean PCS is 52.9. The presence of an adult smoker and increasing number of smokers in the home are both negatively associated with MCS and PCS scores in bivariable analyses (P < 0.001 for each). Non-smoking mothers with at least one smoker in the household had an 11% (95% CI = 0.80-0.99) lower odds of scoring at or above the mean MCS score and a 19% (95% CI = 0.73-0.90) lower odds of scoring at or above the mean PCS score compared to non-smoking mothers with no smokers in the household. There is an evidence of a dose response relationship with increasing number of smokers in the household for PCS (P < 0.001). These findings demonstrate a previously unrecognized child health risk: living with smokers is independently associated with worse physical and mental health among non-smoking mothers.
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Affiliation(s)
- L Sobotova
- Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovakia, Europe
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