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1.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31519792

RESUMO

BACKGROUND: In 2017, we conducted a multistate investigation to determine the source of an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infections, which occurred primarily in children. METHODS: We defined a case as infection with an outbreak strain of STEC O157:H7 with illness onset between January 1, 2017, and April 30, 2017. Case patients were interviewed to identify common exposures. Traceback and facility investigations were conducted; food samples were tested for STEC. RESULTS: We identified 32 cases from 12 states. Twenty-six (81%) cases occurred in children <18 years old; 8 children developed hemolytic uremic syndrome. Twenty-five (78%) case patients ate the same brand of soy nut butter or attended facilities that served it. We identified 3 illness subclusters, including a child care center where person-to-person transmission may have occurred. Testing isolated an outbreak strain from 11 soy nut butter samples. Investigations identified violations of good manufacturing practices at the soy nut butter manufacturing facility with opportunities for product contamination, although the specific route of contamination was undetermined. CONCLUSIONS: This investigation identified soy nut butter as the source of a multistate outbreak of STEC infections affecting mainly children. The ensuing recall of all soy nut butter products the facility manufactured, totaling >1.2 million lb, likely prevented additional illnesses. Prompt diagnosis of STEC infections and appropriate specimen collection aids in outbreak detection. Child care providers should follow appropriate hygiene practices to prevent secondary spread of enteric illness in child care settings. Firms should manufacture ready-to-eat foods in a manner that minimizes the risk of contamination.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Infecções por Escherichia coli/epidemiologia , Escherichia coli O157 , Doenças Transmitidas por Alimentos/epidemiologia , Escherichia coli Shiga Toxigênica , Alimentos de Soja/microbiologia , Adolescente , Idoso , Criança , Creches/estatística & dados numéricos , Pré-Escolar , Infecções por Escherichia coli/microbiologia , Fast Foods/efeitos adversos , Fast Foods/microbiologia , Feminino , Manipulação de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Síndrome Hemolítico-Urêmica/epidemiologia , Síndrome Hemolítico-Urêmica/microbiologia , Humanos , Lactente , Masculino , Recall e Retirada de Produto , Alimentos de Soja/efeitos adversos , Estados Unidos/epidemiologia
2.
Public Health Rep ; 133(6): 749-758, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30300568

RESUMO

In 2015, the University of Washington School of Public Health, Department of Epidemiology established the Student Epidemic Action Leaders (SEAL) team to provide public health students with experience in field epidemiology in state and local public health communicable disease divisions. The University of Washington Department of Epidemiology developed the SEAL team in collaboration with the Washington State Department of Health to offer public health graduate students opportunities to contribute to the real-time needs of public health agencies during a communicable disease event and/or preparedness event. The SEAL team combines classroom and field-based training in public health practice and applied epidemiology. During the first 2 years of the SEAL team (2016-2018), 34 SEALs were placed at 4 agencies contributing more than 1300 hours of assistance on 24 public health projects.


Assuntos
Epidemias/prevenção & controle , Relações Interinstitucionais , Faculdades de Saúde Pública , Estudantes de Saúde Pública , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Humanos , Governo Local , Administração em Saúde Pública , Faculdades de Saúde Pública/organização & administração , Governo Estadual , Washington
3.
N Engl J Med ; 377(21): 2036-2043, 2017 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-29166238

RESUMO

BACKGROUND: In 2016, a multijurisdictional team investigated an outbreak of Shiga toxin-producing Escherichia coli (STEC) serogroup O121 and O26 infections linked to contaminated flour from a large domestic producer. METHODS: A case was defined as infection with an outbreak strain in which illness onset was between December 21, 2015, and September 5, 2016. To identify exposures associated with the outbreak, outbreak cases were compared with non-STEC enteric illness cases, matched according to age group, sex, and state of residence. Products suspected to be related to the outbreak were collected for STEC testing, and a common point of contamination was sought. Whole-genome sequencing was performed on isolates from clinical and food samples. RESULTS: A total of 56 cases were identified in 24 states. Univariable exact conditional logistic-regression models of 22 matched sets showed that infection was significantly associated with the use of one brand of flour (odds ratio, 21.04; 95% confidence interval [CI], 4.69 to 94.37) and with tasting unbaked homemade dough or batter (odds ratio, 36.02; 95% CI, 4.63 to 280.17). Laboratory testing isolated the outbreak strains from flour samples, and whole-genome sequencing revealed that the isolates from clinical and food samples were closely related to one another genetically. Trace-back investigation identified a common flour-production facility. CONCLUSIONS: This investigation implicated raw flour as the source of an outbreak of STEC infections. Although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens.


Assuntos
Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Farinha/envenenamento , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Escherichia coli Shiga Toxigênica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções por Escherichia coli/microbiologia , Feminino , Farinha/microbiologia , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Sorogrupo , Escherichia coli Shiga Toxigênica/genética , Escherichia coli Shiga Toxigênica/isolamento & purificação , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
4.
MMWR Morb Mortal Wkly Rep ; 65(14): 379-81, 2016 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-27078514

RESUMO

During June-July 2015, Public Health-Seattle & King County (PHSKC) and Washington State Department of Health (WADOH) investigated 22 clusters of Salmonella serotype I 4,[5], 12:i:- infections. Serotype I 4,[5], 12:i:- is the fifth most frequently reported Salmonella serotype in the United States, but is uncommon in Washington. On July 29, 2015, WADOH and PHSKC requested assistance from CDC to identify the infection source, determine risk factors, and make recommendations for prevention.


Assuntos
Surtos de Doenças , Farmacorresistência Bacteriana Múltipla , Microbiologia de Alimentos , Carne/microbiologia , Intoxicação Alimentar por Salmonella/epidemiologia , Salmonella/efeitos dos fármacos , Salmonella/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Suínos , Washington/epidemiologia , Adulto Jovem
5.
J Clin Microbiol ; 54(3): 768-70, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26699704

RESUMO

Listeriosis is a serious foodborne infection that disproportionately affects elderly adults, pregnant women, newborns, and immunocompromised individuals. Diagnosis is made by culturing Listeria monocytogenes from sterile body fluids or from products of conception. This report describes the investigations of two listeriosis pseudo-outbreaks caused by contaminated laboratory media made from sheep blood.


Assuntos
Surtos de Doenças , Listeria monocytogenes/genética , Listeriose/epidemiologia , Listeriose/transmissão , Meios de Cultura , Genoma Bacteriano , Humanos , Laboratórios , Listeria monocytogenes/classificação , Listeria monocytogenes/isolamento & purificação , Tipagem de Sequências Multilocus , Filogenia , Estados Unidos/epidemiologia
6.
MMWR Morb Mortal Wkly Rep ; 64(42): 1202-3, 2015 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-26513638

RESUMO

On April 27, 2015, the Whatcom County Health Department (WCHD) in Bellingham, Washington, was notified by a local laboratory regarding three children with presumptive Escherichia coli O157 infection. WCHD interviewed the parents, who indicated that all three children had attended a dairy education event held in a barn April 20­24, 2015, during a school field trip. WCHD, the Washington State Department of Health, and CDC investigated to determine the magnitude of the outbreak, identify risk factors and potential environmental sources of infection, and develop recommendations. A total of 60 cases (25 confirmed and 35 probable) were identified, and 11 patients were hospitalized.


Assuntos
Indústria de Laticínios/educação , Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Escherichia coli O157/isolamento & purificação , Animais , Bovinos , Criança , Microbiologia Ambiental , Humanos , Estudantes/estatística & dados numéricos , Washington/epidemiologia
7.
MMWR Morb Mortal Wkly Rep ; 64(14): 399, 2015 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-25879900

RESUMO

On January 8, 2014, the Ohio Department of Health notified the Oregon Public Health Division (OPHD) of campylobacteriosis in two Ohio residents recently returned from Oregon. The travelers reported consuming chicken liver pâté* at an Oregon restaurant. On January 10, OPHD received additional reports of campylobacteriosis in two persons who had consumed chicken liver pâté at another Oregon restaurant. Campylobacter jejuni was isolated in cultures of fecal specimens from three patients. OPHD investigated to determine the sources of the illnesses and to institute preventive measures.


Assuntos
Infecções por Campylobacter/epidemiologia , Campylobacter jejuni/isolamento & purificação , Surtos de Doenças , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Carne/microbiologia , Animais , Infecções por Campylobacter/microbiologia , Galinhas , Culinária , Fezes/microbiologia , Doenças Transmitidas por Alimentos/microbiologia , Humanos , Fígado , Ohio/epidemiologia , Oregon/epidemiologia , Restaurantes
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