Calling all Campy--how routine investigation and molecular characterization impacts the understanding of campylobacteriosis epidemiology--Alaska, United States, 2004-2013.

Unlike most jurisdictions in the United States, Alaska performs pulsed-field gel electrophoresis (PFGE) characterization of all Campylobacter sp. isolates at the state public health laboratory--a practice that started in 2002. Moreover, in order to ensure early detection and response to campylobacteriosis outbreaks, the Alaska Section of Epidemiology has investigated all incident Campylobacter sp. case reports since 2004. This report summarizes the public health impact of routine incident case investigations and molecular characterization of all Campylobacter sp. isolates. In sum, we found that these efforts have contributed to better characterization of the epidemiology of campylobacteriosis in Alaska, and facilitated more rapid outbreak detection, more public health investigations, and earlier public health interventions.

Sharing milk but not messages: campylobacteriosis associated with consumption of raw milk from a cow-share program in Alaska, 2011.

Alaska public and environmental health authorities investigated a cluster of campylobacteriosis cases among people who had consumed raw, unpasteurized milk obtained from a cow-share program in Alaska. Although raw milk is not permitted by law to be offered commercially, consumers can enter into cow-share agreements whereby they contribute funds for the upkeep of cows and in turn receive a share of the milk for their personal use. Laboratory testing of stool specimens collected from ill persons and from cows on the farm revealed an indistinguishable strain of Campylobacter. In this outbreak, numerous confirmed and suspected cases were not among cow shareholders; therefore, these individuals had not been advised of the potential health hazards associated with consumption of raw milk nor were they informed of the outbreak developments.

Over-representation of Samoan/Pacific Islanders among patients with methicillin-resistant Staphylococcus aureus (MRSA) infections at a large family practice clinic in Anchorage, Alaska, 1996-2000.

Two pediatricians in Anchorage observed that among patients of Samoan/Pacific Islander (S/PI) descent, bacterial wound cultures that grew Staphylococcus aureus often yielded methicillin-resistant isolates. The Alaska Section of Epidemiology performed chart reviews of patients that visited a large family practice clinic in Anchorage, Alaska, from 1996 through April 2000, and who were diagnosed with a skin infection. Eight of 204 patients were identified with culture-confirmed MRSA infections. Eighty percent (4 of 5) of S/PI patients had resistant isolates compared with 12% (4 of 34) of non S/PI patients (Yates corrected chi2 = 8.61, p-value = 0.003). Although subject to limitations, these data support similar findings documented by other studies that suggest MRSA infections disproportionately affect persons of S/PI origin. This study also suggests that it would be prudent to reduce the threshold of clinical suspicion for obtaining a skin culture among S/PI patients in Alaska, and avoid beta-lactam antibiotics until culture results are received.