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Cherry CC, Sureda MEN, Gibbins JD, Hale CR, Stapleton GS, Jones ES, Nichols MC. Large animal veterinarians' knowledge, attitudes, and practices regarding livestock abortion-associated zoonoses in the United States indicate potential occupational health risk. J Am Vet Med Assoc 2022; 260:780-788. [PMID: 35175930 PMCID: PMC9524364 DOI: 10.2460/javma.21.09.0429] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To understand large animal veterinarians' knowledge of select zoonotic diseases that cause livestock abortions and identify barriers to using personal protective equipment (PPE). SAMPLE A convenience sample of 469 veterinarians currently working with livestock. PROCEDURES We sent an electronic survey invitation to large animal veterinarians through various veterinary organizations. Respondents answered questions addressing knowledge and prior experience with select abortion-associated zoonotic diseases, resources available for infection control, attitudes and barriers to PPE use, and demographics. RESULTS Median participant age was 49 years (range, 22 to 82 years), and 54% (235/438) were male. Half of veterinarians (185/348) were contacted 5 or fewer times per year to consult on livestock abortions. No veterinarians surveyed answered all questions on zoonotic disease transmission correctly. Personal protective equipment access varied, from 99% (289/290) having access to gloves to 20% (59/290) having access to respirators. Concerns for spreading disease to other animals (136/289 [47%]) and to other humans (108/287 [38%]) ranked as the most common reported motivators for PPE use. Reported barriers to PPE use among survey participants were the inconvenience of taking PPE into the field (101/286 [35%]) and the inconvenience of wearing PPE (97/286 [34%]). Access to PPE was not correlated with PPE use. CLINICAL RELEVANCE Surveyed veterinarians had limited knowledge of transmission of select abortion-associated zoonotic diseases. Incomplete understanding might lead to inappropriate PPE selection, preventable disease exposure, or missed opportunities for client education. Inconvenience was a primary reason PPE was not used.
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Affiliation(s)
- Cara C. Cherry
- Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA
| | - María E. Negrón Sureda
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA
| | - John D. Gibbins
- Hazard Evaluations and Technical Assistance Branch, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, CDC, Cincinnati, OH
| | - Christa R. Hale
- Western States Division, National Institute for Occupational Safety and Health, CDC, Denver, CO
| | - G. Sean Stapleton
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN,Outbreak Response and Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA
| | - Emma S. Jones
- Office of the Director, Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, CO
| | - Megin C. Nichols
- Outbreak Response and Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA,Corresponding author: Dr. Nichols (Outbreak Response and Prevention Branch, CDC, 1600 Clifton Rd NE, Atlanta, GA 30329; )
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Mowla SJ, Drexler NA, Cherry CC, Annambholta PD, Kracalik IT, Basavaraju SV. Ehrlichiosis and Anaplasmosis among Transfusion and Transplant Recipients in the United States. Emerg Infect Dis 2021; 27:2768-2775. [PMID: 34670661 PMCID: PMC8544963 DOI: 10.3201/eid2711.211127] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 11/30/2022] Open
Abstract
Physicians should be aware that these infections are rare but can have severe outcomes. Ehrlichiosis and anaplasmosis are emerging tickborne diseases that can also be transmitted through blood transfusions or organ transplants. Since 2000, ehrlichiosis and anaplasmosis cases in the United States have increased substantially, resulting in potential risk to transplant and transfusion recipients. We reviewed ehrlichiosis and anaplasmosis cases among blood transfusion and solid organ transplant recipients in the United States from peer-reviewed literature and Centers for Disease Control and Prevention investigations. We identified 132 cases during 1997–2020, 12 transfusion-associated cases and 120 cases in transplant recipients; 8 cases were donor-derived, and in 13 cases illness occurred <1 year after transplant. Disease in the remaining 99 cases occurred ≥1 year after transplant, suggesting donor-derived disease was unlikely. Severe illness or death were reported among 15 transfusion and transplant recipients. Clinicians should be alert for these possible infections among transfusion and transplant recipients to prevent severe complications or death by quickly treating them.
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Cherry CC, Nichols Heitman K, Bestul NC, Kersh GJ. Acute and chronic Q fever national surveillance - United States, 2008-2017. Zoonoses Public Health 2021; 69:73-82. [PMID: 34626097 DOI: 10.1111/zph.12896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii and can manifest in an acute or chronic form. Many persons with acute Q fever are asymptomatic, but some develop a febrile illness, pneumonia or hepatitis. Chronic infections are rare and occur in less than 5% of persons exposed. Forms of chronic Q fever include endocarditis, infection of vascular grafts or aneurysms, osteomyelitis and osteoarthritis. Acute and chronic Q fever are nationally notifiable diseases, and presented here are the incidence, demographics and distribution of acute and chronic Q fever in the United States during 2008-2017. We summarized passive surveillance data from the Centers for Disease Control and Prevention's (CDC) National Notifiable Diseases Surveillance System (NNDSS) and supplemental case report forms (CRFs). Health departments reported 1,109 cases of acute Q fever and 272 chronic Q fever cases to NNDSS during this period. The 10-year average annual incidence for acute Q fever was 0.36 cases per million persons, and the average annual incidence for chronic Q fever was 0.09. Males accounted for nearly 75% of both acute and chronic Q fever cases. Average annual incidence was highest among persons aged 60-69 years for both acute and chronic Q fever (0.70 cases per million persons and 0.25, respectively). As reported through CRFs, many Q fever cases did not have a known exposure to C. burnetii; 60% (n = 380) of acute Q fever cases did not report exposure to animals in the 2 months before symptom onset. Almost 90% (n = 558) did not report exposure to unpasteurized milk. Only 40% (n = 247) of persons with reported Q fever were employed in high-risk occupations. Even though Q fever is a rare disease in the United States, incidence doubled from 2008 to 2017.
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Affiliation(s)
- Cara C Cherry
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kristen Nichols Heitman
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nicolette C Bestul
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee, USA
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Cherry CC, Binder AM. Trends in clinical diagnoses of typhus group rickettsioses among a large U.S. insurance claims database. Zoonoses Public Health 2020; 67:291-299. [PMID: 31984654 DOI: 10.1111/zph.12687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/23/2019] [Indexed: 01/03/2023]
Abstract
Typhus group rickettsioses (TGRs) are vector-borne diseases that include murine typhus (Rickettsia typhi) and epidemic typhus (R. prowazekii). Twentieth-century public health interventions led to dramatic decreases in incidence; little is known about the contemporary TGR prevalence because neither disease is nationally notifiable. We summarized administrative claims data in a commercially insured population to examine trends in TGR medical encounters. We analysed data from 2003 to 2016 IBM® MarketScan® Commercial Databases to identify persons with inpatient or outpatient visits with an International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification TGR-specific code. We summarized epidemiologic characteristics associated with incident diagnosis. We identified 1,799 patients diagnosed with a TGR. Patients resided in 46 states, and most were female (n = 1,019/1,799; 56.6%); the median age was 42 years (range: 0-64 years). Epidemic typhus (n = 931/1,799; 51.8%) was the most common TGRs, followed by murine typhus (n = 722/1,799; 40.1%). The majority of TGR patients were diagnosed in an outpatient setting (n = 1,725/1,799; 95.9%); among hospitalized patients, the majority received a murine typhus diagnosis (n = 67/74; 90.5%). TGRs are rarely diagnosed diseases. More patients were diagnosed with epidemic than murine typhus, even though R. prowazekii transmission requires body louse or flying squirrel exposure. Patients from all geographic regions were diagnosed with murine and epidemic typhus, despite historically recognized ranges for these diseases. The epidemiologic misalignment of insurance claims data versus historic TGRs data highlights the challenges of finding appropriate alternative data sources to serve as a proxy when national surveillance data do not exist.
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Affiliation(s)
- Cara C Cherry
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alison M Binder
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Cherry CC, Kwit NA, Ohms RE, Hammesfahr AM, Pappert R, Petersen JM, Nelson CA, Buttke DE. Tularemia ( Francisella tularensis) in a Black-Tailed Prairie Dog ( Cynomys ludovicianus) Colony. J Wildl Dis 2019; 55:944-946. [PMID: 30920904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Tularemia is a bacterial zoonosis caused by Francisella tularensis. We conducted a serosurvey of black-tailed prairie dogs (Cynomys ludovicianus) in Devils Tower National Monument, Wyoming, US, following an epizootic in voles ( Microtus spp.) due to F. tularensis. Only 1 of 44 (2%) sampled prairie dogs was seropositive for F. tularensis, providing evidence of survival and potentially limited spread among free-ranging prairie dogs.
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Affiliation(s)
- Cara C Cherry
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, Georgia 30333, USA
- Wildlife Health Branch, Biological Resources Division, National Park Service, 1201 Oakridge Drive, Fort Collins, Colorado 80525, USA
| | - Natalie A Kwit
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, Georgia 30333, USA
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, Colorado 80521, USA
| | - Rene E Ohms
- Devils Tower National Monument, National Park Service, PO Box 10, Devils Tower, Wyoming 82714, USA
| | - Amy M Hammesfahr
- Devils Tower National Monument, National Park Service, PO Box 10, Devils Tower, Wyoming 82714, USA
| | - Ryan Pappert
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, Colorado 80521, USA
| | - Jeannine M Petersen
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, Colorado 80521, USA
| | - Christina A Nelson
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, Colorado 80521, USA
| | - Danielle E Buttke
- Wildlife Health Branch, Biological Resources Division, National Park Service, 1201 Oakridge Drive, Fort Collins, Colorado 80525, USA
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Cherry CC, Dietz S, Sauber-Schatz E, Russell S, Proctor J, Buttke D. Characteristics of animal-related motor vehicle crashes in select National Park Service units-United States, 1990-2013. Traffic Inj Prev 2019; 20:58-63. [PMID: 30644778 PMCID: PMC7027590 DOI: 10.1080/15389588.2018.1508835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Nationally, animal-motor vehicle crashes (AVCs) account for 4.4% of all types of motor vehicle crashes (MVCs). AVCs are a safety risk for drivers and animals and many National Park Service (NPS) units (e.g., national park, national monument, or national parkway) have known AVC risk factors, including rural locations and substantial animal densities. We sought to describe conditions and circumstances involving AVCs to guide traffic and wildlife management for prevention of AVCs in select NPS units. METHODS We conducted an analysis using NPS law enforcement MVC data. An MVC is a collision involving an in-transit motor vehicle that occurred or began on a public roadway. An AVC is characterized as a collision between a motor vehicle and an animal. A non-AVC is a crash between a motor vehicle and any object other than an animal or noncollision event (e.g., rollover crash). The final data for analysis included 54,068 records from 51 NPS units during 1990-2013. Counts and proportions were calculated for categorical variables and medians and ranges were calculated for continuous variables. We used Pearson's chi-square to compare circumstances of AVCs and non-AVCs. Data were compiled at the park regional level; NPS parks are assigned to 1 of 7 regions based on the park's location. RESULTS AVCs accounted for 10.4% (5,643 of 54,068) of all MVCs from 51 NPS units. The Northeast (2,021 of 5,643; 35.8%) and Intermountain (1,180 of 5,643; 20.9%) regions had the largest percentage of the total AVC burden. November was the peak month for AVCs across all regions (881 of 5,643; 15.6%); however, seasonality varied by park geographic regions. The highest counts of AVCs were reported during fall for the National Capital, Northeast/Southeast, and Northeast regions; winter for the Southeast region; and summer for Intermountain and Pacific West regions. CONCLUSIONS AVCs represent a public health and wildlife safety concern for NPS units. AVCs in select NPS units were approximately 2-fold higher than the national percentage for AVCs. The peak season for AVCs varied by NPS region. Knowledge of region-specific seasonality patterns for AVCs can help NPS staff develop mitigation strategies for use primarily during peak AVC months. Improving AVC data collection might provide NPS with a more complete understanding of risk factors and seasonal trends for specific NPS units. By collecting information concerning the animal species hit, park managers can better understand the impacts of AVC to wildlife population health.
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Affiliation(s)
- Cara C. Cherry
- Epidemic Intelligence Service, Division of Scientific
Education and Professional Development, Center for Surveillance, Epidemiology, and
Laboratory Services, Centers for Disease Control and Prevention, Atlanta,
Georgia
- Office of Public Health and Wildlife Health Branch,
Biological Resources Division, National Park Service, Fort Collins, Colorado
| | - Stephanie Dietz
- Epidemic Intelligence Service, Division of Scientific
Education and Professional Development, Center for Surveillance, Epidemiology, and
Laboratory Services, Centers for Disease Control and Prevention, Atlanta,
Georgia
| | - Erin Sauber-Schatz
- Centers for Disease Control and Prevention, National Center
for Injury Prevention and Control, Division of Unintentional Injury Prevention,
Atlanta, Georgia
- United States Public Health Service, Commissioned Corps,
Rockville, Maryland
| | - Samuel Russell
- United States Public Health Service, Commissioned Corps,
Rockville, Maryland
- Park Facilities Management Division, National Park Service,
Washington, D.C
| | - Jennifer Proctor
- United States Public Health Service, Commissioned Corps,
Rockville, Maryland
- Office of Risk Management, National Park Service, National
Park Service, Washington, D.C
| | - Danielle Buttke
- Office of Public Health and Wildlife Health Branch,
Biological Resources Division, National Park Service, Fort Collins, Colorado
- United States Public Health Service, Commissioned Corps,
Rockville, Maryland
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Cherry CC, Denison AM, Kato CY, Thornton K, Paddock CD. Diagnosis of Spotted Fever Group Rickettsioses in U.S. Travelers Returning from Africa, 2007-2016. Am J Trop Med Hyg 2018; 99:136-142. [PMID: 29848404 DOI: 10.4269/ajtmh.17-0882] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Spotted fever group rickettsioses (SFGRs), such as African tick bite fever (ATBF), are among the most commonly diagnosed diseases for ill travelers returning from southern Africa. We summarized demographic, clinical, and diagnostic features of imported SFGR cases in U.S. travelers returning from Africa who had laboratory specimens submitted to the Centers for Disease Control and Prevention. Diagnosis of SFGR was performed by indirect immunofluorescence antibody assay, immunohistochemical staining, polymerase chain reaction (PCR), or culture. Cases were defined as probable SFGR, confirmed SFGR, or confirmed ATBF. Clinical and epidemiological categorical variables were described as counts and proportions; continuous variables were described using geometric mean titers, median, and range. One hundred and twenty-seven patients satisfied laboratory criteria for confirmed or probable SFGR. Fever was the most common symptom (N = 88; 69%), followed by ≥ 1 eschars (N = 70; 55%). Paired serums were submitted for 36 patients (28%); 12 patients (33%) had nonreactive initial serum sample but converted to a titer ≥ 64 with the convalescent sample. Twenty-seven patients (21%) had infection with Rickettsia africae based on PCR analysis of eschar swab (N = 8) or biopsy (N = 23). Fifteen patients had eschar biopsy or swab samples and serum sample(s) submitted together; 9 (60%) had PCR-positive eschar results and nonreactive acute serology. Health-care providers should consider SFGR when evaluating patients for a febrile illness with eschar and compatible foreign travel history. Polymerase chain reaction testing of eschar biopsies or swabs provides a confirmed diagnosis in early stages of disease; eschar swabs or biopsies are an underutilized diagnostic technique.
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Affiliation(s)
- Cara C Cherry
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy M Denison
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cecilia Y Kato
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katrina Thornton
- Epidemiology Elective Program, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher D Paddock
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Johnson TL, Graham CB, Boegler KA, Cherry CC, Maes SE, Pilgard MA, Hojgaard A, Buttke DE, Eisen RJ. Prevalence and Diversity of Tick-Borne Pathogens in Nymphal Ixodes scapularis (Acari: Ixodidae) in Eastern National Parks. J Med Entomol 2017; 54:742-751. [PMID: 28028138 PMCID: PMC5657145 DOI: 10.1093/jme/tjw213] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Indexed: 05/08/2023]
Abstract
Tick-borne pathogens transmitted by Ixodes scapularis Say (Acari: Ixodidae), also known as the deer tick or blacklegged tick, are increasing in incidence and geographic distribution in the United States. We examined the risk of tick-borne disease exposure in 9 national parks across six Northeastern and Mid-Atlantic States and the District of Columbia in 2014 and 2015. To assess the recreational risk to park visitors, we sampled for ticks along frequently used trails and calculated the density of I. scapularis nymphs (DON) and the density of infected nymphs (DIN). We determined the nymphal infection prevalence of I. scapularis with a suite of tick-borne pathogens including Borrelia burgdorferi, Borrelia miyamotoi, Anaplasma phagocytophilum, and Babesia microti. Ixodes scapularis nymphs were found in all national park units; DON ranged from 0.40 to 13.73 nymphs per 100 m2. Borrelia burgdorferi, the causative agent of Lyme disease, was found at all sites where I. scapularis was documented; DIN with B. burgdorferi ranged from 0.06 to 5.71 nymphs per 100 m2. Borrelia miyamotoi and A. phagocytophilum were documented at 60% and 70% of the parks, respectively, while Ba. microti occurred at just 20% of the parks. Ixodes scapularis is well established across much of the Northeastern and Mid-Atlantic States, and our results are generally consistent with previous studies conducted near the areas we sampled. Newly established I. scapularis populations were documented in two locations: Washington, D.C. (Rock Creek Park) and Greene County, Virginia (Shenandoah National Park). This research demonstrates the potential risk of tick-borne pathogen exposure in national parks and can be used to educate park visitors about the importance of preventative actions to minimize tick exposure.
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Affiliation(s)
- Tammi L Johnson
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521 (; ; ; ; ; ; )
| | - Christine B Graham
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521 (; ; ; ; ; ; )
| | - Karen A Boegler
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521 (; ; ; ; ; ; )
| | - Cara C Cherry
- Biological Resources Division, Wildlife Health Branch and Office of Public Health, National Park Service, 1201 Oakridge Dr., Suite 200, Fort Collins, CO 80525 ( ; )
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30329-4027
| | - Sarah E Maes
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521 (; ; ; ; ; ; )
| | - Mark A Pilgard
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521 (; ; ; ; ; ; )
| | - Andrias Hojgaard
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521 (; ; ; ; ; ; )
| | - Danielle E Buttke
- Biological Resources Division, Wildlife Health Branch and Office of Public Health, National Park Service, 1201 Oakridge Dr., Suite 200, Fort Collins, CO 80525 (; )
| | - Rebecca J Eisen
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521 (; ; ; ; ; ; )
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Cherry CC, Beer KD, Fulton C, Wong D, Buttke D, Staples JE, Ellis EM. Knowledge and use of prevention measures for chikungunya virus among visitors - Virgin Islands National Park, 2015. Travel Med Infect Dis 2016; 14:475-480. [PMID: 27597388 DOI: 10.1016/j.tmaid.2016.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/30/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND In June 2014, the mosquito-borne chikungunya virus (CHIKV) emerged in the U.S. Virgin Islands (USVI), a location where tourists comprise the majority of the population during peak season (January-April). Limited information is available concerning visitors' CHIKV awareness and prevention measures. METHODS We surveyed a convenience sample of Virgin Islands National Park visitors aged ≥18 years. Respondents completed a questionnaire assessing CHIKV knowledge, attitudes, and practices; health information-seeking practices; and demographics. RESULTS Of 783 persons contacted, 443 (57%) completed the survey. Fewer than half (208/441 [47%]) were aware of CHIKV. During trip preparation, 28% of respondents (126/443) investigated USVI-specific health concerns. Compared with persons unaware of CHIKV, CHIKV-aware persons were more likely to apply insect repellent (134/207 [65%] versus 111/231 [48%]; p < 0.001), wear long-sleeves and long pants (84/203 [41%] versus 57/227 [25%]; p < 0.001), and wear insect repellent-treated clothing (36/204 [18%] versus 22/227 [10%]; p = 0.02). CONCLUSIONS The majority of visitors surveyed did not research destination-related health concerns and were unaware of CHIKV. However, CHIKV awareness was associated with using multiple prevention measures to reduce disease risk. These findings underscore the importance of providing tourists with disease education upon destination arrival.
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Affiliation(s)
- Cara C Cherry
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, USA; Office of Public Health and Wildlife Health Branch, Biological Resources Division, National Park Service, 1201 Oakridge Drive, Fort Collins, CO, USA.
| | - Karlyn D Beer
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, USA; Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE CDC, Atlanta, GA, USA
| | - Corey Fulton
- Epidemiology Elective Program, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, USA; Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd, Fort Collins, CO, USA
| | - David Wong
- Office of Public Health, National Park Service, 4030 Mackland Ave NE, Albuquerque, NM, USA
| | - Danielle Buttke
- Office of Public Health and Wildlife Health Branch, Biological Resources Division, National Park Service, 1201 Oakridge Drive, Fort Collins, CO, USA
| | - J Erin Staples
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd, Fort Collins, CO, USA
| | - Esther M Ellis
- Virgin Islands Department of Health, 3500 Estate Richmond Christiansted, U.S. Virgin Islands
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Kobayashi M, Beer KD, Bjork A, Chatham-Stephens K, Cherry CC, Arzoaquoi S, Frank W, Kumeh O, Sieka J, Yeiah A, Painter JE, Yoder JS, Flannery B, Mahoney F, Nyenswah TG. Community Knowledge, Attitudes, and Practices Regarding Ebola Virus Disease - Five Counties, Liberia, September-October, 2014. MMWR Morb Mortal Wkly Rep 2015; 64:714-8. [PMID: 26158352 PMCID: PMC4584843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
As of July 1, 2015, Guinea, Liberia, and Sierra Leone have reported a total of 27,443 confirmed, probable, and suspected Ebola virus disease (Ebola) cases and 11,220 deaths. Guinea and Sierra Leone have yet to interrupt transmission of Ebola virus. In January, 2016, Liberia successfully achieved Ebola transmission-free status, with no new Ebola cases occurring during a 42-day period; however, new Ebola cases were reported beginning June 29, 2015. Local cultural practices and beliefs have posed challenges to disease control, and therefore, targeted, timely health messages are needed to address practices and misperceptions that might hinder efforts to stop the spread of Ebola. As early as September 2014, Ebola spread to most counties in Liberia. To assess Ebola-related knowledge, attitudes, and practices (KAP) in the community, CDC epidemiologists who were deployed to the counties (field team), carried out a survey conducted by local trained interviewers. The survey was conducted in September and October 2014 in five counties in Liberia with varying cumulative incidence of Ebola cases. Survey results indicated several findings. First, basic awareness of Ebola was high across all surveyed populations (median correct responses = 16 of 17 questions on knowledge of Ebola transmission; range = 2-17). Second, knowledge and understanding of Ebola symptoms were incomplete (e.g., 61% of respondents said they would know if they had Ebola symptoms). Finally, certain fears about the disease were present: >90% of respondents indicated a fear of Ebola patients, >40% a fear of cured patients, and >50% a fear of treatment units (expressions of this last fear were greater in counties with lower Ebola incidence). This survey, which was conducted at a time when case counts were rapidly increasing in Liberia, indicated limited knowledge of Ebola symptoms and widespread fear of Ebola treatment units despite awareness of communication messages. Continued efforts are needed to address cultural practices and beliefs to interrupt Ebola transmission.
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Affiliation(s)
- Miwako Kobayashi
- Epidemic Intelligence Service, CDC,National Center for Immunization and Respiratory Diseases, CDC,Corresponding author: Miwako Kobayashi, , 404-639-2912
| | - Karlyn D. Beer
- Epidemic Intelligence Service, CDC,National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Adam Bjork
- Division of Global HIV/AIDS, Center for Global Health
| | | | - Cara C. Cherry
- Epidemic Intelligence Service, CDC,National Park Service, Biological Resources Division, Wildlife Health Branch/Office of Public Health, Fort Collins, Colorado
| | | | | | | | | | | | - Julia E. Painter
- Epidemic Intelligence Service, CDC,National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | | | | | - Frank Mahoney
- Global Immunization Division, Center for Global Health, CDC
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