Dana Cole, Georgia Division of Public Health, Notifiable Disease Section, Department of Human Resources, 2 Peachtree Free-living Canada Geese and Antimicrobial Resistance

We describe antimicrobial resistance among Escherichia coli isolated from free-living Canada Geese in Georgia and North Carolina (USA). Resistance patterns are compared to those reported by the National Antimicrobial Resistance Monitoring System. Canada Geese may be vectors of antimicrobial resistance and resistance genes in agricultural environments

Middle East respiratory syndrome coronavirus (MERS-CoV) infections in two returning travellers in the Netherlands, May 2014

Two patients, returning to the Netherlands from pilgrimage in Medina and Mecca, Kingdom of Saudi Arabia, were diagnosed with Middle East respiratory syndrome coronavirus (MERS-CoV) infection in May 2014. The source and mode of transmission have not yet been determined. Hospital-acquired infection and community-acquired infection are both possible

Role of Electronic Data Exchange in an International Outbreak Caused by Salmonella enterica Serotype Typhimurium DT204b

From July through September 2000, patients in five European countries were infected with a multidrug-resistant strain of Salmonella Typhimurium DT204b. Epidemiologic investigations were facilitated by the transmission of electronic images (Tagged Image Files) of pulsed-field gel electrophoresis profiles. This investigation highlights the importance of standardized protocols for molecular typing in international outbreaks of foodborne disease

National outbreak of Pseudomonas aeruginosa associated with an aftercare solution following piercings, July to September 2016, England.

We report a national Pseudomonas aeruginosa outbreak from a common source following piercings between July and September 2016 in England. The multi-agency outbreak investigation included active case finding, microbiological testing of environmental samples and case specimens including Variable Number Tandem Repeat (VNTR) typing and a retrospective cohort study. Overall, 162 outbreak cases (29 confirmed, 14 probable and 119 possible) and 14 non-outbreak cases were identified; all confirmed cases had ear piercings (93% cartilage). Outbreak cases were predominantly female (95%) and had a median age of 18 years (interquartile range: 13-56 years). Nineteen outbreak cases required surgery under general anaesthetic The same outbreak VNTR type (11,3,5,3,3,3,6,4,7) was isolated from bottles of an aftercare solution from a single manufacturer and in specimens from confirmed cases who attended eight different piercing studios supplied with this product. In the cohort study, use of aftercare solution was associated with becoming a case (aOR: 4.60, 95% confidence interval: 1.65-12.90). Environmental, microbiological and epidemiological investigations confirmed that contamination during production of aftercare solution was the source of this national outbreak; highlighting challenges in the regulation of a cosmetic products used in the piercing industry and that guidance on piercing aftercare may need to be reviewed

広島県内介護保険施設・病院等における給食施設の食中毒発生時の食事提供マニュアルの整備状況

介護保険施設・病院等の給食施設では、食中毒が発生した場合においても入所者、入院患者への食事提供を継続しなければならず、被害拡大防止対策や再発防止対策を講じなければならない中で、この責務を果たすことは施設にとって大きな課題である。そこで、広島県内A保健所管内における介護保険施設・病院等の53給食施設を対象として、食中毒発生時における食事提供マニュアルの整備状況を調査し、危機管理対策が適正に講じられているかどうかを把握することを目的とした。食中毒対応体制を確立するための施設からの課題としては、組織・人材管理項目では「代行従事者の確保」が、食事管理項目では「一般食以外の提供先」が、施設・設備管理項目では「盛り付け場所の確保」「洗浄場所の確保」が挙げられた。食中毒発生時の食事提供マニュアルを作成していた施設は介護老人福祉施設・介護老人保健施設の39.3%、病院の64.0%であった。食中毒発生時の食事提供に関する保健衛生行政に対する要望は「食事提供マニュアルの作成指針(チェックリスト)の提示」、「模擬訓練の実施」、「食事提供を支援する組織づくり(地域協議会など)」の順に多かった。これらのことから、食中毒発生時において入所者・入院患者の食事提供が円滑に行えるよう平時より介護保険施設・病院等の給食施設と保健所、地域が連携して食事提供マニュアルを作成し、模擬訓練を定期的に実施することが必要であると考えられた。"In case food poisoning breaks out at welfare facilities for the elderly or hospitals, a major priority is to limit the damage by ensuring that the outbreak spreads no further and to secure substitute food for residents. In 2003 and 2004, we conducted investigations as to whether manuals were available for coping with food poisoning. This was done using questionnaires and personal interviews at 28 welfare facilities and 25 hospitals within a specific area of Hiroshima Prefecture. The figures are as follows: 39.3% of the facilities and 64.0% of the hospitals had manuals for coping with food poisoning. Problems in making out manuals in the facilities are as follows: ""to secure agent staff"", ""to secure a place to serve food"", and ""to secure substitute special food"". Problems in making out manuals in the hospitals are as follows: ""to secure agent staff"" and ""to secure substitute special food"". We formed ""check lists"" of those who had manuals readily available for coping with food poisoning and distributed the result all those involved. Check lists are comprised of 13 units such as ""how to establish a system for dealing with the outbreak of food poisoning"", ""distribution of substitute food"", ""to secure a place to serve food"", and ""to secure agent staff"". It is important that the manual defines exactly what is involved in case of an outbreak of food poisoning. We make a point of conducting a practical verification for the purpose of improving the ability of staff members to cope with the outbreak of food poisoning, and revising the manuals more effectively."原著Original国立情報学研究所で電子

Factors influencing psychological distress during a disease epidemic: Data from Australia's first outbreak of equine influenza

BACKGROUND: In 2007 Australia experienced its first outbreak of highly infectious equine influenza. Government disease control measures were put in place to control, contain, and eradicate the disease; these measures included movement restrictions and quarantining of properties. This study was conducted to assess the psycho-social impacts of this disease, and this paper reports the prevalence of, and factors influencing, psychological distress during this outbreak. METHODS: Data were collected using an online survey, with a link directed to the affected population via a number of industry groups. Psychological distress, as determined by the Kessler 10 Psychological Distress Scale, was the main outcome measure. RESULTS: In total, 2760 people participated in this study. Extremely high levels of non-specific psychological distress were reported by respondents in this study, with 34% reporting high psychological distress (K10 > 22), compared to levels of around 12% in the Australian general population. Analysis, using backward stepwise binary logistic regression analysis, revealed that those living in high risk infection (red) zones (OR = 2.00; 95% CI: 1.57-2.55; p < 0.001) and disease buffer (amber) zones (OR = 1.83; 95% CI: 1.36-2.46; p < 0.001) were at much greater risk of high psychological distress than those living in uninfected (white zones). Although prevalence of high psychological distress was greater in infected EI zones and States, elevated levels of psychological distress were experienced in horse-owners nationally. Statistical analysis indicated that certain groups were more vulnerable to high psychological distress; specifically younger people, and those with lower levels of formal educational qualifications. Respondents whose principal source of income was from horse-related industry were more than twice as likely to have high psychological distress than those whose primary source of income was not linked to horse-related industry (OR = 2.23; 95% CI: 1.82-2.73; p < 0.001). CONCLUSION: Although, methodologically, this study had good internal validity, it has limited generalisability because it was not possible to identify, bound, or sample the target population accurately. However, this study is the first to collect psychological distress data from an affected population during such a disease outbreak and has potential to inform those involved in assessing the potential psychological impacts of human infectious diseases, such as pandemic influenza.13 page(s

Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017

Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205254/Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16-25801 and RIVM-HAV16-090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34%) cases were confirmed; VRD_521_2016 and RIVM-HAV16-090 accounted for 92% of these. Among confirmed cases with available epidemiological data, 92% (361/393) were unvaccinated, 43% (83/195) travelled to Spain during the incubation period and 84% (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.info:eu-repo/semantics/publishedVersio