During the 2012 outbreak of West Nile virus in the United States, approximately one third of the cases were in Texas. Of those, about half occurred in northern Texas. Models based on infected blood ...donors and persons with neuroinvasive disease showed, respectively, that ≈0.72% and 1.98% of persons in northern Texas became infected.
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Melioidosis, caused by the bacterium
Burkholderia pseudomallei,
is an uncommon infection that is typically associated with exposure to soil and water in tropical and subtropical environments. It is ...rarely diagnosed in the continental United States. Patients with melioidosis in the United States commonly report travel to regions where melioidosis is endemic. We report a cluster of four non–travel-associated cases of melioidosis in Georgia, Kansas, Minnesota, and Texas. These cases were caused by the same strain of
B. pseudomallei
that was linked to an aromatherapy spray product imported from a melioidosis-endemic area.
Four cases of non–travel-associated melioidosis (caused by
Burkholderia pseudomallei
) that were identified across the United States were associated with the use of a contaminated aromatherapy room spray.
Monkeypox is a rare, sometimes life-threatening zoonotic infection that occurs in west and central Africa. It is caused by Monkeypox virus, an orthopoxvirus similar to Variola virus (the causative ...agent of smallpox) and Vaccinia virus (the live virus component of orthopoxvirus vaccines) and can spread to humans. After 39 years without detection of human disease in Nigeria, an outbreak involving 118 confirmed cases was identified during 2017-2018 (1); sporadic cases continue to occur. During September 2018-May 2021, six unrelated persons traveling from Nigeria received diagnoses of monkeypox in non-African countries: four in the United Kingdom and one each in Israel and Singapore. In July 2021, a man who traveled from Lagos, Nigeria, to Dallas, Texas, became the seventh traveler to a non-African country with diagnosed monkeypox. Among 194 monitored contacts, 144 (74%) were flight contacts. The patient received tecovirimat, an antiviral for treatment of orthopoxvirus infections, and his home required large-scale decontamination. Whole genome sequencing showed that the virus was consistent with a strain of Monkeypox virus known to circulate in Nigeria, but the specific source of the patient's infection was not identified. No epidemiologically linked cases were reported in Nigeria; no contact received postexposure prophylaxis (PEP) with the orthopoxvirus vaccine ACAM2000.
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Brucellosis is an uncommon disease in the US, but Texas reports approximately a third of cases. We review the investigation of a pair of mother-infant cases that were unique in the demographics, the ...nature of travel exposure and the resulting brucellosis exposure in a hospital's delivery suite and laboratory. These cases illustrate the changing nature of travel and the need to obtain a relevant travel history and adequate laboratory procedures. Clinicians and laboratory workers in Texas need to understand that brucellosis remains an endemic disease, but that its epidemiology is changing.
Background. Listeriosis, a life-threatening foodborne illness caused by Listeria monocytogenes, affects ∼ 2500 Americans annually. Between July and October 2002, an uncommon strain of L. ...monocytogenes caused an outbreak of listeriosis in 9 states. Methods. We conducted case finding, a case-control study, and traceback and microbiological investigations to determine the extent and source of the outbreak and to propose control measures. Case patients were infected with the outbreak strain of L. monocytogenes between July and November 2002 in 9 states, and control patients were infected with different L. monocytogenes strains. Outcome measures included food exposure associated with outbreak strain infection and source of the implicated food. Results. Fifty-four case patients were identified; 8 died, and 3 pregnant women had fetal deaths. The case-control study included 38 case patients and 53 control patients. Case patients consumed turkey deli meat much more frequently than did control patients (P =.008, by Wilcoxon rank-sum test). In the 4 weeks before illness, 55% of case patients had eaten deli turkey breast more than 1–2 times, compared with 28% of control patients (odds ratio, 4.5; 95% confidence interval, 1.3–17.1). Investigation of turkey deli meat eaten by case patients led to several turkey processing plants. The outbreak strain was found in the environment of 1 processing plant and in turkey products from a second. Together, the processing plants recalled >30 million pounds of products. Following the outbreak, the US Department of Agriculture' Food Safety and Inspection Service issued new regulations outlining a L. monocytogenes control and testing program for ready-to-eat meat and poultry processing plants. Conclusions. Turkey deli meat was the source of a large multistate outbreak of listeriosis. Investigation of this outbreak helped guide policy changes designed to prevent future L. monocytogenes contamination of ready-to-eat meat and poultry products.
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During 2012, four north-central Texas counties experienced high West Nile virus (WNV) disease incidence. Aerial insecticide spraying was conducted in two counties. To evaluate the effect of spraying ...on WNV disease, we calculated incidence rate ratios (IRRs) in treated and untreated areas by comparing incidence before and after spraying; for unsprayed areas, before and after periods were defined by using dates from a corresponding sprayed area. In treated areas, WNV neuroinvasive disease incidence before and after spraying was 7.31/100,000 persons and 0.28/100,000 persons, respectively; the IRR was 26.42 (95% confidence interval CI: 12.42-56.20). In untreated areas, the before and after incidence was 4.80/100,000 persons and 0.45/100,000 persons, respectively; the IRR was 10.57 (95% CI: 6.11-18.28). The ratio of IRRs was 2.50 (95% CI: 0.98-6.35). Disease incidence decreased in both areas, but the relative change was greater in aerial-sprayed areas.
The Texas Division of Emergency Management, the City of Dallas Animal Services, and the Dallas County Emergency Operations Center provided assistance. The AVMA organized the Ebola Companion Animal ...Response Plan Working Group, which provided constructive discussion and input during the quarantine period and generated additional recommended protocols on the basis of this experience. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. The authors thank Dr. David A. Norwood for assistance in sample testing; Lieutenant Colonel Kathleen Gibson, Elizabeth Grimes, Matthew Becker, and Sergeant Michael McNaney for efforts to develop an Ebola virus testing capacity for military working dogs and the initial verification of testing of dog blood; and Dr. Eleanor Green for providing support to the Texas A&M Veterinary Emergency Team. In October 2014, a health-care worker who had been part of the treatment team for the first laboratory-confirmed case of Ebola virus disease imported to the United States developed symptoms of Ebola virus disease. A presumptive positive reverse transcription PCR assay result for Ebola virus RNA in a blood sample from the worker was confirmed by the CDC, making this the first documented occurrence of domestic transmission of Ebola virus in the United States. The Texas Department of State Health Services commissioner issued a control order requiring disinfection and decontamination of the health-care worker's residence. This process was delayed until the patient's pet dog (which, having been exposed to a human with Ebola virus disease, potentially posed a public health risk) was removed from the residence. This report describes the movement, quarantine, care, testing, and release of the pet dog, highlighting the interdisciplinary, one-health approach and extensive collaboration and communication across local, county, state, and federal agencies involved in the response.
Shigella outbreaks often continue for months and are linked frequently to poor hygiene and hand washing. Such outbreaks are found often in day care facilities, but rarely are reported in schools. We ...present the investigation of an outbreak in autumn 2007 at a building that housed an elementary school and a middle school in separate wings in a small Texas city north of Dallas-Fort Worth.
We canvassed local hospitals, school attendance records, and physician offices for cases. Ill individuals were interviewed using a standard questionnaire for symptoms, disease onset, and the presence of the illness in an ill person's household.
A music teacher was the index case for this outbreak of gastrointestinal illness caused by S. sonnei. Ten percent of the students in the school building were ill, and 15 households had secondary cases. Installing liquid soap in dispensers in student restrooms was the initial control measure, followed by sustained instruction in hand washing, scheduled hand washing times, and monitored cleaning and disinfection procedures for surfaces and inanimate objects. Enhanced surveillance detected no new cases in the school district.
Appropriate soap supplies and repeated instruction in hand washing and its monitoring were needed to control the outbreak.
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