Case Series of Laboratory-Associated Zika Virus Disease, United States, 2016-2019.

Zika virus diagnostic testing and laboratory research increased considerably when Zika virus began spreading through the Americas in 2015, increasing the risk for potential Zika virus exposure of laboratory workers and biomedical researchers. We report 4 cases of laboratory-associated Zika virus disease in the United States during 2016-2019. Of these, 2 were associated with needlestick injuries; for the other 2 cases, the route of transmission was undetermined. In laboratories in which work with Zika virus is performed, good laboratory biosafety practices must be implemented and practiced to reduce the risk for infection among laboratory personnel.

Antibody Titers Reactive With Rickettsia rickettsii in Blood Donors and Implications for Surveillance of Spotted Fever Rickettsiosis in the United States.

BACKGROUND: Since 2000, the reported prevalence of tick-borne spotted fever rickettsiosis has increased considerably. We compared the level of antibody reactivity among healthy blood donors from 2 widely separated regions of the United States and evaluated the impact of antibody prevalence on public health surveillance in one of these regions. METHODS: Donor serum samples were evaluated by indirect immunofluorescence antibody assay to identify immunoglobulin G (IgG) antibodies reactive with Rickettsia rickettsii. The Georgia Department of Public Health (GDPH) analyzed characteristics of cases from 2016 surveillance data to evaluate the utility of laboratory surveillance for case assessment. RESULTS: Of the Georgia donors (n = 1493), 11.1% demonstrated antibody titers reactive with R. rickettsii at titers ≥64, whereas 6.3% of donors from Oregon and Washington (n = 1511) were seropositive. Most seropositive donors had a titer of 64; only 3.1% (n = 93) of all donors had titers ≥128. During 2016, GDPH interviewed 243 seropositive case patients; only 28% (n = 69) met inclusion criteria in the national case definition for spotted fever rickettsiosis. CONCLUSIONS: These findings suggest that a single IgG antibody titer is an unreliable measure of diagnosis and could inaccurately affect surveillance estimates that define magnitude and clinical characteristics of Rocky Mountain spotted fever and other spotted fever rickettsioses.

Georgia's Collaborative Approach to Expanding Mosquito Surveillance in Response to Zika Virus: Year Two.

With the continued increase in international travel and immigration to Georgia, the Department of Public Health (DPH) continued its mission to prevent and respond to Zika virus (ZIKV) transmission. METHODS: We analyzed surveillance data from the DPH to compare the geographical distribution of counties conducting surveillance, total number, and overall percentage of mosquito species collected in 2016 and 2017. Mosquito surveillance in 2017 was mapped by county and species using ArcMap 10.2.0. RESULTS: From 2016 and 2017, mosquito surveillance increased from 60 to 159 counties (165% increase). A total of 145,346 mosquitoes were trapped and identified in 2016 compared to 152,593 in 2017 (5.43% increase). There was a difference in the type of mosquito species found by year. Some species collected in previous years were not collected in 2017, while other species found in 2017 were not previously collected during mosquito surveillance. Also, certain mosquito species were found outside of their expected geographical range. CONCLUSION: The continued collaborative response to ZIKV by the DPH allowed a continued increase in its surveillance program. Existing and new partnerships continued to develop with military and local health departments to expand and share data. This additional surveillance data allowed DPH to make sound public health decisions regarding mosquito-borne disease risks and close gaps in data related to vector distribution.