Impact of Restaurant Hygiene Grade Cards on Foodborne-Disease Hospitalizations in Los Angeles County

Although health departments routinely inspect restaurants to assess compliance with established hygienic standards, few data are available on the effectiveness of these efforts in preventing foodborne disease. The study reported here assessed the impact on foodborne-disease hospitalizations in Los Angeles County of a restaurant hygiene grading system that utilized publicly posted grade cards. The grading system was introduced in January 1998. Hospital discharge data on foodborne-disease hospitalizations were analyzed for Los Angeles County and, as a control, for the rest of California during the period 1993–2000. Ordinary least-squares regression analysis was done to measure the effect of the grading program on these hospitalizations. After baseline temporal and geographic trends were adjusted for, the restaurant hygiene grading program was associated with a 13.1 percent decrease (p < .01) in the number of foodborne-disease hospitalizations in Los Angeles County in the year following implementation of the program (1998). This decrease was sustained over the next two years (1999–2000). The results suggest that restaurant hygiene grading with public posting of results is an effective intervention for reducing the burden of foodborne disease

Multistate Shigellosis Outbreak and Commercially Prepared Food, United States

In 2000, shigellosis traced to a commercially prepared dip developed in 406 persons nationwide. An ill employee may have inadvertently contaminated processing equipment. This outbreak demonstrates the vulnerability of the food supply and how infectious organisms can rapidly disseminate through point-source contamination of a widely distributed food item

The Impact of Neurocysticercosis in California: A Review of Hospitalized Cases

<div><p>To assess the burden of neurocysticercosis (NCC) in California we examined statewide hospital discharge data for 2009. There were 304 cases hospitalized with NCC identified (incidence = 0.8 per 100,000). Cases were mostly Latino (84.9%), slightly more likely to be male than female (men 57.6%, women 42.4%) with an average age of 43.5 years. A majority of cases were hospitalized in Southern California (72.1%) and many were hospitalized in Los Angeles County (44.7%). Men were more likely than women to have severe disease including hydrocephalus (29.7% vs. 18.6%, p = 0.027), resulting in longer hospitalizations (>4 days, 48.0% vs. 32.6%, p = 0.007) that were more costly (charge>$40 thousand men = 46.9$17 million; estimated hospital costs exceeded $5 million. Neurocysticercosis causes appreciable disease and exacts a considerable economic burden in California.</p> </div

Demographics of Persons Hospitalized with Neurocysticercosis in California, 2009.

<p>*Northern CA; 48 northern most counties. Southern CA; 10 southern most counties.</p><p>Population data obtained from the CA Department of Finance.</p

Neurocysticercosis hospitalizations; additional diagnoses, procedures performed and hospital utilization by gender, CA 2009 (N = 304).

<p>This figure shows that men hospitalized with neurocysticercosis have more severe symptoms requiring a longer and more costly hospitalization than women with neurocysticercosis. Specifically, men hospitalized with neurocysticercosis were more likely to have an additional diagnosis of hydrocephalus, to have a hospitalization exceeding four days and to have a hospital charge exceeding 40,000 dollars as compared to women hospitalized with neurocysticercosis.</p

Use of Statewide Hospital Discharge Data to Evaluate the Economic Burden of Neurocysticercosis in Los Angeles County (1991–2008)

Statewide hospital discharge data were used to assess the economic burden of neurocysticercosis in Los Angeles County (LAC) from 1991 through 2008. A neurocysticercosis hospitalization was defined as having a discharge diagnosis of cysticercosis in addition to convulsions, seizures, hydrocephalus, cerebral edema or cerebral cysts. This study identified 3,937 neurocysticercosis hospitalizations, with the number of annual hospitalizations remaining relatively unchanged over the study period (R2 = 0.01), averaging 219 per year (range 180–264). The total of all neurocysticercosis hospitalization charges over the study period was $136.2 million, averaging$7.9 million per year. The average charge per patient was $37.6 thousand and the most common payment method was Medicaid (43.9%), followed by private insurance (24.5%). The average length of stay was 7.2 days. The substantial number of hospitalizations and significant economic cost underscore the importance of neurocysticercosis in LAC

Industry Sectors Highly Affected by Worksite Outbreaks of Coronavirus Disease, Los Angeles County, California, USA, March 19–September 30, 2020

Worksites with on-site operations have experienced coronavirus disease (COVID-19) outbreaks. We analyzed data for 698 nonresidential, nonhealthcare worksite COVID-19 outbreaks investigated in Los Angeles County, California, USA, during March 19, 2020‒September 30, 2020, by using North American Industry Classification System sectors and subsectors. Nearly 60% of these outbreaks occurred in 3 sectors: manufacturing (n = 184, 26.4%), retail trade (n = 137, 19.6%), and transportation and warehousing (n = 73, 10.5%). The largest number of outbreaks and largest number and highest incidence rate of outbreak-associated cases occurred in manufacturing. Furthermore, 7 of the 10 industry subsectors with the highest incidence rates were within manufacturing. Approximately 70% of outbreak-associated case-patients reported Hispanic ethnicity. Facilities employing more on-site staff had larger and longer outbreaks. Identification of highly affected industry sectors and subsectors is necessary for targeted public health planning, outreach, and response, including ensuring vaccine access, to reduce burden of COVID-19 in vulnerable workers

Strongyloidiasis-Related Deaths in the United States, 1991–2006

The objective of this study was to 1) assess the incidence of strongyloidiasis in the United States, 2) evaluate demographic and regional associations, and 3) identify comorbid conditions as risk factors for death. A population-based case–control study was performed by using mortality data during 1991–2006. We identified 347 strongyloidiasis deaths (0.79 per 10 million deaths, 14–29 deaths per year), which decreased slightly over time. Deaths occurred primarily among older (median age = 66.0 years), white (57.6%) and Hispanic (22.2%) men (69.2%), residing in the Southeastern United States (49.3%). Associated health conditions included chronic obstructive pulmonary disease (28.7%, odds ratio [OR] = 4.0, 95% confidence interval [CI] = 3.0–5.4) and infection with human immunodeficiency virus (12.5%, OR = 4.6, 95% CI = 2.7–7.9). Strongyloidiasis deaths in the second half of the study period (1999–2006) were less likely to be associated with chronic obstructive pulmonary disease (19.4%, OR = 1.2, 95% CI = 0.7–1.9), but continued to be associated with human immunodeficiency virus infection (12.9%, OR = 2.8, 95% CI = 1.3–6.0). Early detection and treatment of at-risk patients with latent strongyloidiasis infections is needed to reduce strongyloidiasis mortality