Rise in Murine Typhus in Galveston County, Texas, USA, 2018.

Murine typhus, an undifferentiated febrile illness caused by Rickettsia typhi, is increasing in prevalence and distribution throughout Texas. In 2018, a total of 40 cases of murine typhus were reported in Galveston County. This increase, unprecedented since the 1940s, highlights the importance of awareness by physicians and public health officials.

An outbreak of pertussis in rural Texas: an example of the resurgence of the disease in the United States.

During 2012, an increase in the number of pertussis cases or outbreaks was reported among most states within the United States. The majority of these cases included previously vaccinated children between the ages of 7-10 years. This underscores the growing concern regarding current immunization practices and vaccine efficacy, especially as it pertains to pertussis prevention within this age group. In the fall of 2012, an outbreak of pertussis occurred within a school district in a rural Texas county that was reflective of this national pattern. Our objective is to describe this outbreak, highlight the similarities with the national trend, and identify strategies for better disease prevention. The cases in this outbreak were interviewed and laboratory testing done. Information regarding exposure and immunization history among cases was obtained. Immunization audits of the affected institutions were also conducted. We performed a descriptive analysis of the collected data using EPI-INFO software v.3.5.3. A total of 34 cases were identified in this outbreak, of which 23 were PCR confirmed and 11 were epidemiologically linked. Ages ranged from 5 months to 12 years, and 62 % were among children aged 7-10 years. All cases were up-to-date on their pertussis vaccinations. Immunization coverage rate was over 90 % within each of the affected institutions. The characteristics of this outbreak bear striking similarities to the current national trend in terms of age groups and immunization status of the affected cases. Increased focus on this vulnerable target group, including heightened scrutiny of vaccine efficacy and delivery, is indicated.

Challenges in Investigating a Salmonellosis Outbreak in a Correctional Facility.

Timely reporting of disease outbreak and access to the outbreak site are necessary for prompt investigation and control. Local health departments (LHDs) establish the reporting time frames, methods, and communication channels within their jurisdictions in advance. This report describes a salmonellosis outbreak investigation in a federal correctional center (FCC) that was delayed due to issues with jurisdictional ownership and with separate reporting protocols for the FCC. The setting of the outbreak within an FCC posed additional unique challenges to the outbreak investigation. These challenges resulted in the outbreak response being delayed by 6 days and inconclusive investigation. It is recommended that LHDs and FCCs work together to create an advance protocol for improved public health coordination, oversight, and response.