RESUMO
Between July 2018 and May 2019, Corynebacterium diphtheriae was isolated from eight patients with non-respiratory infections, seven of whom experienced homelessness and had stayed at shelters in King County, WA, USA. All isolates were microbiologically identified as nontoxigenic C. diphtheriae biovar mitis. Whole-genome sequencing confirmed that all case isolates were genetically related, associated with sequence type 445 and differing by fewer than 24 single-nucleotide polymorphisms (SNPs). Compared to publicly available C. diphtheriae genomic data, these WA isolates formed a discrete cluster with SNP variation consistent with previously reported outbreaks. Virulence-related gene content variation within the highly related WA cluster isolates was also observed. These results indicated that genome characterization can readily support epidemiology of nontoxigenic C. diphtheriae.
Assuntos
Infecções por Corynebacterium/diagnóstico , Corynebacterium diphtheriae/classificação , Polimorfismo de Nucleotídeo Único , Sequenciamento Completo do Genoma/métodos , Adulto , Idoso , Corynebacterium diphtheriae/genética , Corynebacterium diphtheriae/isolamento & purificação , Surtos de Doenças , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Pessoas Mal Alojadas , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Fatores de Virulência/genética , WashingtonRESUMO
BACKGROUND: We sought to describe travel-related illness among our residents and gain insight into targeting pre-travel health advice to prevent travel-related illness. METHODS: A supplemental travel questionnaire was developed and administered for cases with a legally notifiable communicable disease reported in 2011-2012, who spent at least part of their exposure period outside the United States. RESULTS: Among 451 cases meeting the eligibility criteria, 259 were interviewed. Forty four percent reported receiving pre-travel advice. Two-thirds adhered fully with risk behavior recommendations; 94% followed immunization recommendations partially or fully; and 84% adhered fully with malaria prophylaxis recommendations. The primary reasons for not obtaining pre-travel advice were being unaware of the need (47.5%), or believing they already knew what to do (34.5%). Adults (OR = 2.8, 95% CI = 1.4-5.5), males (OR = 1.8, 95% CI = 1.1-3.0), those born outside the United States (OR = 2.0, 95% CI = 1.1-3.7), and those with planning time under two weeks (OR = 4.8, 95% CI = 1.5-15.9) or travel duration less than 7 days (OR = 7.9, 95% CI = 3.0-20.9) were more likely to travel without seeking pre-travel advice. CONCLUSIONS: The majority of cases reported not receiving pre-travel advice. Understanding the predictors of failure to receive pre-travel advice may help target public health prevention efforts.
