On March 30, 2020, Public Health - Seattle and King County (PHSKC) was notified of a confirmed case of coronavirus disease 2019 (COVID-19) in a resident of a homeless shelter and day center (shelter ...A). Residents from two other homeless shelters (B and C) used shelter A's day center services. Testing for SARS-CoV-2, the virus that causes COVID-19, was offered to available residents and staff members at the three shelters during March 30-April 1, 2020. Among the 181 persons tested, 19 (10.5%) had positive test results (15 residents and four staff members). On April 1, PHSKC and CDC collaborated to conduct site assessments and symptom screening, isolate ill residents and staff members, reinforce infection prevention and control practices, provide face masks, and advise on sheltering-in-place. Repeat testing was offered April 7-8 to all residents and staff members who were not tested initially or who had negative test results. Among the 118 persons tested in the second round of testing, 18 (15.3%) had positive test results (16 residents and two staff members). In addition to the 31 residents and six staff members identified through testing at the shelters, two additional cases in residents were identified during separate symptom screening events, and four were identified after two residents and two staff members independently sought health care. In total, COVID-19 was diagnosed in 35 of 195 (18%) residents and eight of 38 (21%) staff members who received testing at the shelter or were evaluated elsewhere. COVID-19 can spread quickly in homeless shelters; rapid interventions including testing and isolation to identify cases and minimize transmission are necessary. CDC recommends that homeless service providers implement appropriate infection control practices, apply physical distancing measures including ensuring resident's heads are at least 6 feet (2 meters) apart while sleeping, and promote use of cloth face coverings among all residents (1).
To estimate costs of labor and materials by the University of Washington (UW) and state and local public health departments (PHDs) to respond to the February to June 2017 UW mumps outbreak, where 42 ...cases were identified among students (primarily sorority and fraternity members), staff, and associated community members.
We applied standard cost analysis methodology using a combined public health and university perspective to examine the cost of responding to the outbreak.
UW's Seattle campus encompasses 703 acres with approximately 32 000 undergraduate students. Nearly 15% of the undergraduate population are members of fraternities or sororities. Housing for the fraternities and sororities is adjacent to the UW campus and consists of 50 houses.
During the outbreak, customized costing tools based on relevant staff or faculty positions and activities were provided to the UW and Public Health-Seattle & King County, populated by each person participating in the outbreak response, and then collected and analyzed. Laboratory hours and material costs were collected from the Washington Department of Health and the Minnesota Department of Health.
Labor and material costs provided by the UW and PHDs during the outbreak were collected and categorized by payer and activity.
Total costs to the UW and PHDs in responding to the outbreak were $282 762 ($6692 per case). Of these, the UW spent $160 064, while PHDs spent $122 098. Labor accounted for 77% of total outbreak costs, and UW response planning and coordination accounted for the largest amount of labor costs ($75 493) overall.
Given the current university and public health department budget constraints, the response to the outbreak amounted to a significant use of resources. Labor was the largest driver of costs for the outbreak response; UW labor costs-related to campus response planning and coordination-dominated the total economic burden from public health and university perspectives.
Between July 2018 and May 2019,
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
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
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
.
Vaccination protects against infection with SARS-CoV-2 (the virus that causes COVID-19) and related hospitalizations (1,2), and surviving a previous infection protects against B.1.1.7 (Alpha) and ...B.1.617.2 (Delta) variant reinfections† (2). Since the SARS-CoV-2 B.1.1.529 (Omicron) variant became predominant in the United States in late December 2021, reported reinfections have increased§ (3). Early reinfections (those occurring within 90 days of previous infection) are not well understood (4). Because some persons have prolonged detection of viral RNA after infection,¶ repeat positive nucleic acid amplification test (NAAT) results within 90 days could reflect prolonged shedding from earlier infection, presenting technical challenges to documenting and characterizing early reinfections. Characteristics of SARS-CoV-2 Omicron variant infection in 10 persons within 90 days of a previous SARS-CoV-2 B.1.617.2 (Delta) variant infection — four states, October 2021–January 2022Return to your place in the text Patient State Age group, yrs* Race and ethnicity High-risk preexisting condition† Infection no.§ Test date COVID-19 vaccination status Suspected exposure Symptoms No. of days between infections A Vermont 5–11 White, NH No 1 Oct 19, 2021 None School Yes 87 2 Jan 14, 2022 1 mRNA dose (Dec 17, 2021) Household Yes B Vermont 5–11 White, NH No 1 Oct 30, 2021 None School Yes 77 2 Jan 15, 2022 1 mRNA dose (Jan 8, 2022) Family gathering Yes C Vermont 5–11 White, NH Yes 1 Nov 21, 2021 None Household Yes 69 2 Jan 29, 2022 None Household Yes D Vermont 0–4 White, NH No 1 Nov 11, 2021 None School Yes 76 2 Jan 26, 2022 None Unknown Unknown E Vermont 25–39 Black, NH Yes 1 Dec 16, 2021 2 mRNA doses (Sep/Oct 2021) Health care Yes (hospitalized) 40 2 Jan 25, 2022 (As above) Health care No F¶ Wisconsin 5–11 White, NH No 1 Nov 27, 2021 None School Yes 45 2 Jan 11, 2022 None Household (patient G) Yes G¶ Wisconsin 5–11 White, NH No 1 Dec 4, 2021 None Household (patient F) Yes 31 2 Jan 4, 2022 None Unknown Yes H¶ Wisconsin 5–11 White, NH No 1 Nov 27, 2021 None Household (patient F) Yes 52 2 Jan 18, 2022 None Household (patient G) Yes I Washington 12–17 White, NH No 1 Nov 23, 2021 None Household Yes 23 2 Dec 16, 2021 None School sport No J Rhode Island 65–74 Unknown Unknown 1 Nov 15, 2021 None LTCF No 57 2 Jan 11, 2022 None LTCF Unknown Abbreviations: LTCF = long-term care facility; NH = non-Hispanic. * At time of first infection. † Obesity, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease and bronchiectasis, neurocognitive disorders, coronary arteriosclerosis, and other heart disease. § In all cases, the first infection was with Delta variant and the second was with Omicron variant. ¶ Patients were in one household.
On May 1, 2017, in Washington, Public Health-Seattle & King County was notified of a possible Baylisascaris procyonis infection in a previously healthy male child aged 19 months. The patient had been ...evaluated on April 26 for a 1-week history of irritability followed by tremors of his extremities, ataxia, and decreased interactivity. On examination, the patient was afebrile with an inability to sit or stand unaided; complete blood count revealed eosinophilia; magnetic resonance imaging of the brain indicated diffuse, patchy white matter lesions, alongside patchy, enhancing lesions in both cerebellar hemispheres. This report describes the first laboratory-confirmed B. procyonis human infection in Washington. Children aged <2 years exhibit frequent hand-to-mouth behaviors and might be at increased risk for baylisascariasis through ingestion of soil and other potentially contaminated material. Among the 31 documented disease cases, 17 were among children aged <2 years.
During June-July 2015, Public Health-Seattle & King County and Washington State Department of Health 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 US, but is uncommon in Washington. On Jul 29, 2015, WADOH and PHSKC requested assistance from CDC to identify the infection source, determine risk factors, and make recommendations for prevention. On the basis of cases investigated before August 2015, a supplemental questionnaire that went into more detail in addressing meat and livestock exposures was developed. Further study of the epidemiology and etiology of ASSuT resistance and Salmonella I 4,5, 12:i:- is recommended. This was the largest Salmonella outbreak in Washington in recent history, and highlights that pork is an important source for human Salmonella infections. Best practices in all parts of the pork production industry, from farm to processing plant, can help reduce the risk for future outbreaks.
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