Legionella bacteria are naturally found in freshwater. In the right environment, these bacteria can cause illness when people inhale or aspirate aerosolized droplets of water containing Legionella. ...Legionnaires' disease (LD) is a lower respiratory illness characterized by severe pneumonia from these bacteria. This infection often causes hospitalization and is fatal in 1 out of 10 cases. The incidence rate of LD is increasing in the US due to a variety of factors, including aging infrastructure and population, increased awareness and testing, and urinary antigen test availability. Pontiac fever is a milder illness caused by Legionella bacteria that does not cause pneumonia and usually does not require hospitalization. Legionella bacteria are known to grow in large, complex water systems that are not adequately maintained. Internal and external factors contribute to Legionella growth in building water systems. Studies show that approximately 90% of LD outbreaks associated with buildings are due to a preventable environmental deficiency.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Although measles was declared eliminated from the United States in 2000, measles cases and outbreaks continue to occur, resulting from importations of the disease from countries where it remains ...endemic.
We describe the epidemiology of international importations of measles virus into the United States during the postelimination era.
From 2001 to 2016, 553 imported measles cases were reported to the Centers for Disease Control and Prevention. A median of 28 importations occurred each year (range: 18-80). The median age of imported case-patients was 18 years (range: 3 months-75 years); 87% were unvaccinated or had an unknown vaccination status. US residents (as opposed to foreign visitors) accounted for 62% of imported measles cases. Overall, 62% of all imported case-patients reported travel to countries in the Western Pacific and European Regions of the World Health Organization during their exposure periods. The number of measles importations from specific countries was related to the incidence of measles in and the volume of travel to and from the source country.
Our findings emphasize the importance of measles vaccination of US residents aged ≥6 months before international travel according to the Advisory Committee on Immunization Practices recommendations and supporting global measles elimination efforts.
Abstract
Background
Mumps is an acute viral illness that classically presents with parotitis. Although the United States experienced a 99% reduction in mumps cases following implementation of the ...2-dose vaccination program in 1989, mumps has resurged in the past 10 years.
Methods
We assessed the epidemiological characteristics of mumps outbreaks with ≥20 cases reported in the United States electronically through the National Notifiable Diseases Surveillance System and from supplemental outbreak data through direct communications with jurisdictions from July 2010 through December 2015. Mumps cases were defined using the 2012 Council of State and Territorial Epidemiologists case definition.
Results
Twenty-three outbreaks with 20–485 cases per outbreak were reported in 18 jurisdictions. The duration of outbreaks ranged from 1.5 to 8.5 months (median, 3 months). All outbreaks involved close-contact settings; 18 (78%) involved universities, 16 (70%) occurred primarily among young adults (median age, 18–24 years), and 9 (39%) occurred in highly vaccinated populations (2-dose measles-mumps-rubella vaccine coverage ≥85%).
Conclusions
During 2010–2015, multiple mumps outbreaks among highly vaccinated populations in close-contact settings occurred. Most cases occurred among vaccinated young adults, suggesting that waning immunity played a role. Further evaluation of risk factors associated with these outbreaks is warranted.
Recent mumps outbreaks in the United States have primarily occurred in highly vaccinated populations in close-contact settings.
The 1999 cessation of vaccination against adenovirus types 4 and 7 among US Army trainees resulted in reemergence of acute respiratory disease (ARD) outbreaks. The 2011 implementation of a ...replacement vaccine led to dramatic and sustained decreases in ARD cases, supporting continuation of vaccination in this population at high risk for ARD.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
Measles elimination (interruption of endemic measles virus transmission) in the United States was declared in 2000; however, the number of cases and outbreaks have increased in ...recent years. We characterized the epidemiology of measles outbreaks and measles transmission patterns after elimination to identify potential gaps in the US measles control program.
Methods
We analyzed national measles notification data from 1 January 2001 to 31 December 2019. We defined measles infection clusters as single cases (isolated cases not linked to additional cases), 2-case clusters, or outbreaks with ≥3 linked cases. We calculated the effective reproduction number (R) to assess changes in transmissibility and reviewed molecular epidemiology data.
Results
During 2001–2019, a total of 3873 measles cases, including 747 international importations, were reported in the United States; 29% of importations were associated with outbreaks. Among 871 clusters, 69% were single cases and 72% had no spread. Larger and longer clusters were reported since 2013, including 7 outbreaks with >50 cases lasting >2 months, 5 of which occurred in known underimmunized, close-knit communities. No measles lineage circulated in a single transmission chain for >12 months. Higher estimates of R were noted in recent years, although R remained below the epidemic threshold of 1.
Conclusions
Current epidemiology continues to support the interruption of endemic measles virus transmission in the United States. However, larger and longer outbreaks in recent postelimination years and emerging trends of increased transmission in underimmunized communities emphasize the need for targeted approaches to close existing immunity gaps and maintain measles elimination.
Introduction Medical information systems during past military deployments had limited injury surveillance capability as data were not accessible during deployments and did not capture causes of ...injury. This paper describes nonbattle injury (NBI) results from an ongoing surveillance program that identifies injury occurrences and causes during deployments for Operations Iraqi Freedom (Iraq) and Enduring Freedom (Afghanistan). Methods U.S. Army soldiers medically air evacuated from Iraq (March 2003–December 2006) or Afghanistan (October 2001–December 2006) were identified from air evacuation records that provided demographics, casualty type, diagnosis, and patient history. For NBI cases, the patient history was used to identify and code injury cause, incident circumstances, and body region. Descriptive statistics were used to describe and compare NBIs evacuated from Iraq and Afghanistan. Results In all, 27,563 soldiers in Iraq and 4165 in Afghanistan were air evacuated. NBIs accounted for 35% and 36% of cases, respectively, and were the largest single category of evacuations for both operations. Distributions for leading categories of NBI diagnosis (fracture, inflammation/pain, and dislocation) and body region (back, knee, and wrist/hand) were similar for both operations. Leading NBI causes were the same for both operations—sports/physical training (19%–21%), falls/jumps (18%), and motor vehicle–related incidents (12%–16%)—but the proportion of motor vehicle incidents was higher in Iraq ( p <0.001). Conclusions Routinely collected air evacuation records provided the basis for ongoing injury surveillance for Iraq and Afghanistan. NBI was the largest category of evacuations from both operations. Leading NBI causes were similar to those identified for previous deployments and many should be preventable.
To characterize and compare severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-specific immune responses in plasma and gingival crevicular fluid (GCF) from nursing home residents during and ...after natural infection.
Prospective cohort.
Nursing home.
SARS-CoV-2-infected nursing home residents.
A convenience sample of 14 SARS-CoV-2-infected nursing home residents, enrolled 4-13 days after real-time reverse transcription polymerase chain reaction diagnosis, were followed for 42 days. After diagnosis, plasma SARS-CoV-2-specific pan-Immunoglobulin (Ig), IgG, IgA, IgM, and neutralizing antibodies were measured at 5 time points, and GCF SARS-CoV-2-specific IgG and IgA were measured at 4 time points.
All participants demonstrated immune responses to SARS-CoV-2 infection. Among 12 phlebotomized participants, plasma was positive for pan-Ig and IgG in all 12 participants. Neutralizing antibodies were positive in 11 participants; IgM was positive in 10 participants, and IgA was positive in 9 participants. Among 14 participants with GCF specimens, GCF was positive for IgG in 13 participants and for IgA in 12 participants. Immunoglobulin responses in plasma and GCF had similar kinetics; median times to peak antibody response were similar across specimen types (4 weeks for IgG; 3 weeks for IgA). Participants with pan-Ig, IgG, and IgA detected in plasma and GCF IgG remained positive throughout this evaluation, 46-55 days after diagnosis. All participants were viral-culture negative by the first detection of antibodies.
Nursing home residents had detectable SARS-CoV-2 antibodies in plasma and GCF after infection. Kinetics of antibodies detected in GCF mirrored those from plasma. Noninvasive GCF may be useful for detecting and monitoring immunologic responses in populations unable or unwilling to be phlebotomized.
PDF
