Human Salmonellosis Outbreak Linked to Salmonella Typhimurium Epidemic in Wild Songbirds, United States, 2020-2021.

Salmonella infection causes epidemic death in wild songbirds, with potential to spread to humans. In February 2021, public health officials in Oregon and Washington, USA, isolated a strain of Salmonella enterica serovar Typhimurium from humans and a wild songbird. Investigation by public health partners ultimately identified 30 illnesses in 12 states linked to an epidemic of Salmonella Typhimurium in songbirds. We report a multistate outbreak of human salmonellosis associated with songbirds, resulting from direct handling of sick and dead birds or indirect contact with contaminated birdfeeders. Companion animals might have contributed to the spread of Salmonella between songbirds and patients; the outbreak strain was detected in 1 ill dog, and a cat became ill after contact with a wild bird. This outbreak highlights a One Health issue where actions like regular cleaning of birdfeeders might reduce the health risk to wildlife, companion animals, and humans.

Preliminary Incidence and Trends of Infections Caused by Pathogens Transmitted Commonly Through Food - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2022.

Each year, infections from major foodborne pathogens are responsible for an estimated 9.4 million illnesses, 56,000 hospitalizations, and 1,350 deaths in the United States (1). To evaluate progress toward prevention of enteric infections in the United States, the Foodborne Diseases Active Surveillance Network (FoodNet) conducts surveillance for laboratory-diagnosed infections caused by eight pathogens transmitted commonly through food at 10 U.S. sites. During 2020-2021, FoodNet detected decreases in many infections that were due to behavioral modifications, public health interventions, and changes in health care-seeking and testing practices during the COVID-19 pandemic. This report presents preliminary estimates of pathogen-specific annual incidences during 2022, compared with average annual incidences during 2016-2018, the reference period for the U.S. Department of Health and Human Services' Healthy People 2030 targets (2). Many pandemic interventions ended by 2022, resulting in a resumption of outbreaks, international travel, and other factors leading to enteric infections. During 2022, annual incidences of illnesses caused by the pathogens Campylobacter, Salmonella, Shigella, and Listeria were similar to average annual incidences during 2016-2018; however, incidences of Shiga toxin-producing Escherichia coli (STEC), Yersinia, Vibrio, and Cyclospora illnesses were higher. Increasing culture-independent diagnostic test (CIDT) usage likely contributed to increased detection by identifying infections that would have remained undetected before widespread CIDT usage. Reducing pathogen contamination during poultry slaughter and processing of leafy greens requires collaboration among food growers and processors, retail stores, restaurants, and regulators.

Preliminary Incidence and Trends of Infections Caused by Pathogens Transmitted Commonly Through Food - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2016-2021.

To evaluate progress toward prevention of enteric infections in the United States, the Foodborne Diseases Active Surveillance Network (FoodNet) conducts active population-based surveillance for laboratory-diagnosed infections caused by Campylobacter, Cyclospora, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC), Shigella, Vibrio, and Yersinia at 10 U.S. sites. This report summarizes preliminary 2021 data and describes changes in annual incidence compared with the average annual incidence for 2016-2018, the reference period for the U.S. Department of Health and Human Services' (HHS) Healthy People 2030 goals for some pathogens (1). During 2021, the incidence of infections caused by Salmonella decreased, incidence of infections caused by Cyclospora, Yersinia, and Vibrio increased, and incidence of infections caused by other pathogens did not change. As in 2020, behavioral modifications and public health interventions implemented to control the COVID-19 pandemic might have decreased transmission of enteric infections (2). Other factors (e.g., increased use of telemedicine and continued increase in use of culture-independent diagnostic tests [CIDTs]) might have altered their detection or reporting (2). Much work remains to achieve HHS Healthy People 2030 goals, particularly for Salmonella infections, which are frequently attributed to poultry products and produce, and Campylobacter infections, which are frequently attributed to chicken products (3).

Syndromic Gastrointestinal Panel Diagnostic Tests Have Changed our Understanding of the Epidemiology of Yersiniosis-Foodborne Diseases Active Surveillance Network, 2010-2021.

Background: In the US, yersinosis was understood to predominantly occur in winter and among Black or African American infants and Asian children. Increased use of culture-independent diagnostic tests (CIDTs) has led to marked increases in yersinosis diagnoses. Methods: We describe differences in the epidemiology of yersiniosis diagnosed by CIDT versus culture in 10 US sites, and identify determinants of health associated with diagnostic method. Results: Annual reported incidence increased from 0.3/100 000 in 2010 to 1.3/100 000 in 2021, particularly among adults ≥18 years, regardless of race and ethnicity, and during summer months. The proportion of CIDT-diagnosed infections increased from 3% in 2012 to 89% in 2021. An ill person's demographic characteristics and location of residence had a significant impact on their odds of being diagnosed by CIDT. Conclusions: Improved detection due to increased CIDT use has altered our understanding of yersinosis epidemiology, however differential access to CIDTs may still affect our understanding of yersinosis.

Public health for the twenty-first century: what role do veterinarians in clinical practice play?

All veterinarians, regardless of their formal job description, serve the public good and contribute to public health. The public health activities veterinarians engage in most frequently in clinical practice are in the areas of disease detection, reporting, and prevention. This article provides a brief overview of the basic functions of public health, while emphasizing the public health roles that veterinary clinicians play in their day-to-day practice of veterinary medicine and how they might extend their interest and involvement in this field. The multidisciplinary nature of the field of public health and the benefits of collaboration with other health care and public health professionals are also discussed.

Veterinary public health in a problem-based learning curriculum at the Western University of Health Sciences.

As detailed in the Association of Schools of Public Health / Association of American Veterinary Medical Colleges 2007 Joint Symposium on Veterinary Public Health, veterinary public health (VPH) can no longer be viewed as a unique sub-specialty of veterinary medicine. Rather, its practice pervades nearly every aspect of the veterinary profession, regardless of whether the practitioner is engaged in small-animal, large-animal, research, corporate, or military practice. In congruence with the practice of VPH, the teaching of VPH should also pervade nearly every aspect of veterinary education. Accordingly, at Western University of Health Sciences, College of Veterinary Medicine (WU-CVM), public health is not simply taught as an individual course but, rather, is interwoven into almost every aspect of the curriculum, continually emphasizing the relevance of this discipline to the practice of veterinary medicine. This article outlines the teaching philosophy of WU-CVM, provides an overview of the curriculum, and describes the integral nature of public health throughout all four years of the educational program.

Survival analysis to evaluate associations between periodontal disease and the risk of development of chronic azotemic kidney disease in cats evaluated at primary care veterinary hospitals.

OBJECTIVE To examine potential associations between periodontal disease (PD) and the risk of development of chronic azotemic kidney disease (CKD) among cats and determine whether the risk of CKD increases with severity of PD. DESIGN Retrospective cohort study. ANIMALS 169, 242 cats. PROCEDURES Cats were evaluated ≥ 3 times at any of 829 hospitals from January 1, 2002, through June 30, 2013. Cats with an initial diagnosis of PD of any stage (n = 56,414) were frequency matched with cats that had no history or evidence of PD (112,828) by age and year of study entry. Data on signalment, PD, and other conditions potentially related to CKD were extracted from electronic medical records. Cox proportional hazards modeling was used to estimate the association of PD with CKD after controlling for covariates. RESULTS PD was associated with increased risk of CKD; risk was highest for cats with stage 3 or 4 PD. Risk of CKD increased with age. Purebred cats had greater risk of CKD than mixed-breed cats. General anesthesia within the year before study exit and diagnosis of cystitis at any point prior to study exit (including prior to study entry) were each associated with increased CKD risk. Diagnosis of diabetes mellitus or hepatic lipidosis at any point prior to study exit was associated with decreased CKD risk. CONCLUSIONS AND CLINICAL RELEVANCE The findings supported the benefit of maintaining good oral health and can be useful to veterinarians for educating owners on the importance of preventing PD in cats.

A small animal clinician's guide to critical appraisal of the evidence in scientific literature.

There is a tremendous amount of medical literature available to the clinician. The challenge is to identify information that is useful and relevant for the patient population of interest. This article provides an overview of important considerations when critically appraising a report, such as selection of the study population, features of the study design used, potential sources of bias, and evaluation of the statistical evidence.

Comparative attractiveness of two chicken breeds to mosquitoes in southern California.

Each transmission season (April-October), mosquito control districts deploy more than 2,000 white leghorn hens as sentinels in California's arbovirus surveillance program. In 2002, Rhode Island red hybrids were used instead, because of insufficient availability of leghorns. Although arboviral seroconversions occurred in both breeds, their attractiveness to host-seeking mosquitoes was not compared. During August and September 2004, Florida Medical Entomology Laboratory traps, each containing 1 hen, were deployed twice weekly at each of 4 fixed locations at a southern California wetland area. The breed at each location was alternated each trap-night to account for intersite variation in the mosquito population. Six chickens of each breed were rotated through the traps to account for interchicken variation in mosquito attractiveness. Although the mosquito counts varied significantly among trap locations, no significant difference was found between the 2 breeds. Sera collected biweekly detected seroconversions to Flavivirus in 4 of 6 red and 1 of 6 white chickens, not a statistically significant difference. Larger sample sizes or experimental infection of different chicken breeds may identify differences in their response to arbovirus infection.

Antibody response to Culex tarsalis salivary gland antigens among sentinel chickens in California.

The arboviral surveillance program in California depends in part on sentinel chickens to detect western equine encephalomyelitis virus, St. Louis encephalitis virus, and West Nile virus activity. From 2000 through 2002, 1,578 serum specimens from 34 sentinel flocks in northern and southern California were tested for antibodies to Culex tarsalis salivary gland antigens. Sentinel chickens that were seropositive for mosquito salivary gland antigens were more likely to seroconvert to St. Louis encephalitis virus than those seronegative for salivary gland antigens. Flocks with mosquito traps located < 50 feet away had a reduced antibody response to mosquito salivary gland antigens. The use of sentinel chickens and mosquito traps for arboviral surveillance should be standardized to ensure that surveillance data from different sites are comparable and that flocks have comparable opportunities for mosquito exposure. Sentinel chickens should be accessible to potential mosquito vectors to maximize their sensitivity for detecting arboviral activity.

Detection of chicken antibodies to mosquito salivary gland antigens by enzyme immunoassay.

Sentinel chickens are used to detect western equine encephalomyelitis, St. Louis encephalitis, and West Nile virus activity. Flocks that receive high mosquito exposure will be most effective for surveillance purposes. However, mosquito population indices at the flock sites may only provide an indirect measure of potential exposure. Therefore, we developed an indirect enzyme immunoassay to detect chicken antibodies to salivary gland antigens (SGAs) from Culex tarsalis, the primary arbovirus vector in California. Chickens fed upon by Cx. tarsalis developed an antibody response that was proportional to the amount of exposure. Cross-reactivity between sera from Cx. tarsalis-exposed chickens and SGAs from Culex pipiens quinquefasciatus, Culex pipiens pipiens, Ochlerotatus melanimon, and Ochlerotatus sierrensis was likely due to shared SGAs among these species. This serologic assay for mosquito exposure could be used to evaluate the sensitivity of sentinel flocks for detecting arboviral activity.

Important emerging bacterial zoonotic infections affecting the immunocompromised.

The immunocompromised are at particular risk for infection with zoonotic diseases. Persons can be temporarily immunocompromised due to pregnancy or developmental stage (i.e. infants); longer-term or permanent states of immunosuppression can occur as a result of immunosuppressive treatment following cancer or organ transplant, or from infectious diseases, such as AIDS. The focus of this review article is on emerging bacterial zoonotic diseases that are of particular concern among the immunocompromised. Factors that affect disease emergence can include factors such as human demographics and behavior; technology and industry; economic development and land use; international travel and commerce; microbial adaptation and change; and breakdown of public health measures. The immunocompromised need to take precautions when engaging in seemingly normal activities such as food preparation; caring for companion animals; and recreational or occupational activities. The immunocompromised are not only more susceptible to infection, but often suffer more serious sequelae as a result of infection. This review article provides an overview of the major foodborne, respiratory, and vector-borne bacterial pathogens that affect the immunocompromised. The major categories of immunodeficiency are described. In addition, measures that can be taken to prevent infection, including the role of health education, are discussed.

Acute encephalitis hospitalizations, California, 1990-1999: unrecognized arboviral encephalitis?

Historically, Western equine encephalomyelitis and St. Louis encephalitis caused substantial human and equine illness and death in California. This study describes the epidemiology of encephalitis with data from 13,807 patients hospitalized in California with acute encephalitis from 1990 through 1999. The incidence of encephalitis hospitalizations decreased over this period. The greatest proportion of case-patients was hospitalized in the winter. Encephalitis of unspecified origin was the most common diagnosis, and arboviral encephalitis was the least common. Some California counties had concurrent increases in encephalitis rates and in detected arboviral activity in sentinel chickens and mosquito vectors. However, a diagnosis of arboviral encephalitis was made for few hospitalized patients in these counties during these periods. Although some arboviral encephalitis cases may have been undiagnosed, such cases probably did not occur frequently. Active hospital-based surveillance during periods of heightened sylvatic arboviral activity could increase detection of arboviral encephalitis.