Human Rabies - Utah, 2018.

On November 3, 2018, the Utah Department of Health (UDOH) was notified of a suspected human rabies case in a man aged 55 years. The patient's symptoms had begun 18 days earlier, and he was hospitalized for 15 days before rabies was suspected. As his symptoms worsened, he received supportive care, but he died on November 4. On November 7, a diagnosis of rabies was confirmed by CDC. This was the first documented rabies death in a Utah resident since 1944. This report summarizes the patient's clinical course and the subsequent public health investigation, which determined that the patient had handled several bats in the weeks preceding symptom onset. Public health agencies, in partnership with affected health care facilities, identified and assessed the risk to potentially exposed persons, facilitated receipt of postexposure prophylaxis (PEP), and provided education to health care providers and the community about the risk for rabies associated with bats. Human rabies is rare and almost always fatal. The findings from this investigation highlight the importance of early recognition of rabies, improved public awareness of rabies in bats, and the use of innovative tools after mass rabies exposure events to ensure rapid and recommended risk assessment and provision of PEP.

Outbreak of E. coli O157:H7 Infections Associated with Exposure to Animal Manure in a Rural Community - Arizona and Utah, June-July 2017.

On June 26, 2017, a hospital in southern Utah notified the Utah Department of Health of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infections in two children from a small community on the Arizona-Utah border. Both children developed hemolytic uremic syndrome, characterized by hemolytic anemia, acute kidney failure, and thrombocytopenia and died within a few days of illness onset. Over the next few days, several more STEC-associated illnesses were reported in residents of the community. A joint investigation by local and state health agencies from Arizona and Utah and CDC was initiated to identify the outbreak source and prevent additional cases; a total of 12 cases were identified, including the two children who died. Investigators initially explored multiple potential sources of illness; epidemiologic and environmental information revealed cow manure contact as the likely initial cause of the outbreak, which was followed by subsequent person-to-person transmission. One of the outbreak strains was isolated from bull and horse manure collected from a yard near a community household with two ill children. Local health agencies made recommendations to the public related to both animal contact and hand hygiene to reduce the risk for STEC transmission. Animal or animal manure contact should be considered a potential source of STEC O157:H7 during outbreaks in communities where ruminants are kept near the home.

Surveillance data on pesticide and agricultural chemical releases and associated public health consequences in selected US states, 2003-2007.

BACKGROUND: While pesticides and agricultural chemicals are used to increase crop production and to reduce the spread of disease, their toxic nature also has the potential to threaten human health. Releases of pesticides and agricultural chemicals have resulted in human illness and death. This analysis examines releases of pesticides and agricultural chemicals and their associated injuries captured by the Hazardous Substances Emergency Events Surveillance (HSEES) system from 2003-2007. METHODS: Simple descriptive statistics are presented. Comparisons were made to data from all HSEES events when possible. RESULTS: Analysis of the data shows that farm workers are at particular risk for injury and that the most frequent months for releases of pesticides and agricultural chemicals were the spring planting months of April through June. Releases of pesticides and agricultural chemicals occurred more often during transport, had higher frequencies of patient decontamination associated with them, and lower frequencies of evacuation and shelter-in place orders compared with all HSEES events. CONCLUSION: Since exposures are precipitated by behavioral and environmental factors, especially in occupational settings, future interventions targeting employers, and transporters of agricultural chemicals, as well as physicians, are recommended. These interventions should be customized to fit local conditions.