Outbreak of Listeria monocytogenes in an urban poultry flock.

BACKGROUND: Listeria monocytogenes infection is most commonly recognized in ruminants, including cattle, sheep, and goats; but it is rarely diagnosed in poultry. This report describes an outbreak of L. monocytogenes in a backyard poultry flock. Also, it points out the importance of collaboration between veterinarians and public health departments and the possible implications of zoonotic diseases. CASE PRESENTATION: Depression, lack of appetite, labored breathing, and increased mortality were noted for 5 months in several affected birds within the flock. The pathologic changes in the internal organs of infected birds included severe myocarditis, pericarditis, pneumonia, hepatitis, and splenitis. No lesions were noted in the brain. Gram-positive organisms were seen in histologic sections of the heart and spleen. Listeria monocytogenes was detected by real time PCR from formalin fixed heart and spleen, and was isolated from fresh lung, spleen, and liver. This isolate was identified as L. monocytogenes serotype 4b by 16S rDNA sequencing and by PCR-based serotyping assay. CONCLUSIONS: This is the first report describing outbreak of L. monocytogenes in backyard poultry flock in Washington State and use of molecular methods to confirm L. monocytogenes infection from formalin fixed tissues.

A survey of veterinarian involvement in zoonotic disease prevention practices.

OBJECTIVE: To determine the extent to which practicing veterinarians in King County, Washington, engaged in commonly recommended practices for the prevention of zoonotic diseases. DESIGN: Cross-sectional survey. Sample Population-Licensed veterinarians practicing clinical medicine in King County, Washington. PROCEDURES: A survey was sent between September and November 2006 to 454 licensed veterinarians practicing clinical medicine in King County. RESULTS: 370 valid responses were received. A high proportion (280/362 [77%]) of respondents agreed that it was very important for veterinarians to educate clients on zoonotic disease prevention, but only 43% (158/367) reported that they had initiated discussions about zoonotic diseases with clients on a daily basis, and only 57% (203/356) indicated that they had client educational materials on zoonotic diseases available in their practices. Thirty-one percent (112/360) of respondents indicated that there were no written infection-control guidelines for staff members in the practice, and 28% (105/371) reported having been infected with a zoonotic disease in practice. CONCLUSIONS AND CLINICAL RELEVANCE: Results illustrated that veterinarians recognize their important role in zoonotic disease prevention and suggested that veterinarians would welcome stronger partnerships with public health agencies and other health professionals in this endeavor. Methods to increase veterinarians' involvement in zoonotic disease prevention include discussing zoonotic diseases more frequently with clients, physicians, and public health agencies; encouraging higher risk individuals to discuss zoonotic diseases; having educational materials on zoonotic diseases available for clients; improving infection-control practices; and ensuring that continuing education courses on zoonotic diseases are regularly available.

HIV testing behaviors and attitudes after adoption of name-to-code HIV case surveillance in Washington State.

Controversy over HIV reporting in Washington State raised concerns that name-to-code reporting might reduce HIV testing. We assessed HIV testing and the influence of reporting among people at risk for HIV. An anonymous survey was conducted 9 months after HIV reporting began. Recruitment for men who have sex with men was at bars; high-risk heterosexuals at a sexually transmitted disease clinic; and injection drug users at needle exchange sites. Eighty-nine percent of 267 participants had been tested for HIV at least once but only half reported testing regularly. Injection drug users and men who have sex with men were more likely than HRH to report regular testing. Main reasons for delaying testing were thinking that HIV exposure was unlikely or not wanting to think about being HIV positive; concern about government reporting was cited by only 2%. Over half the respondents hadn't heard about the new name-to-code HIV reporting mechanism, although 69% thought there was some type of HIV reporting. Only 18% correctly identified the mechanism of HIV reporting. HIV prevention programs should focus on the most common reasons for delaying or avoiding HIV testing: believing that one has not been exposed to HIV, and the fear of learning that one is HIV positive.

The Washington state "name-to-code" HIV reporting system: a public health perspective.

The advent of highly active anti-retroviral treatment for human immunodeficiency virus (HIV) infection in the mid-1990s, along with other new developments in HIV understanding, epidemiology, and care, led local and state public health officials to recommend to the Washington State Board of Health in 1996 that asymptomatic HIV infection be added to the list of conditions reportable to public health by name. A controversy over reporting followed that lasted over two years. Although a "name-to-code" compromise had been suggested early on, it gained acceptance only after key stakeholders faced substantial public health, medical, and general community opposition to unique identifier reporting. This article describes the processes of adopting HIV reporting in Washington State, the nature of the reporting system, and how the issues were ultimately resolved.

Support among persons infected with HIV for routine health department contact for HIV partner notification.

Public health partner notification (PN) services are provided inconsistently to persons diagnosed with HIV/AIDS in the United States, and some community groups representing persons with HIV/AIDS have opposed widespread application of PN. We surveyed persons with HIV recently reported to our health department and a random sample of HIV-infected persons attending an HIV/AIDS clinic. A total of 95 persons, of whom 76 (80%) were men who have sex with men, completed an anonymous self-administered questionnaire. Eighty-four percent of participants believed the health department should routinely offer everyone diagnosed with HIV help in notifying their partners; 79% indicated they would be somewhat or very likely to provide information to a doctor, case worker, or health department employee for purposes of PN; and 20% indicated they wanted help in notifying a recent sex partner. Seventy-eight percent of participants believed the health department should contact all HIV-infected persons after diagnosis to help them access medical care and social services, and 68% wanted the health department to contact them about the availability of medical or social services. In contrast to common public perceptions, these results suggest that most persons with HIV support health departments routinely contacting people after HIV diagnosis and that many want assistance with PN.