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In October 2016, Seattle Children's Hospital notified the Washington State Department of Health (DOH) and CDC of a cluster of acute onset of limb weakness in children aged ≤14 years. All patients had distinctive spinal lesions largely restricted to gray matter detected by magnetic resonance imaging (MRI), consistent with acute flaccid myelitis (AFM). On November 3, DOH issued a health advisory to local health jurisdictions requesting that health care providers report similar cases. By January 24, 2017, DOH and CDC had confirmed 10 cases of AFM and excluded two suspected cases among residents of Washington during September-November 2016. Upper respiratory tract, stool, rectal, serum, buccal, and cerebrospinal fluid (CSF) specimens were tested for multiple pathogens. Hypothesis-generating interviews were conducted with patients or their parents to determine commonalities between cases. No common etiology or source of exposure was identified. Polymerase chain reaction (PCR) testing detected enterovirus D68 (EV-D68) in nasopharyngeal swabs of two patients, one of whom also tested positive for adenovirus by PCR, and detected enterovirus A71 (EV-A71) in the stool of a third patient. Mycoplasma spp. immunoglobulin M (IgM) titer was elevated in two patients, but both had upper respiratory swabs that tested negative for Mycoplasma spp. by PCR. Clinicians should maintain vigilance for AFM and report cases as soon as possible to state or local health departments. [ABSTRACT FROM AUTHOR]

On July 5, 2013, CDC was notified of two cases of laboratory-confirmed measles in recently adopted children from an orphanage in Henan Province, China. To find potentially exposed persons, CDC collaborated with state and local health departments, the children's adoption agency, and airlines that carried the adoptees. Two additional measles cases were identified, one in a family member of an adoptee and one in a third adopted child from China. To prevent further importation of measles, CDC worked with health officials in China, including "panel physicians" contracted by the U.S. Department of State to conduct the overseas medical examinations required for all immigrants and refugees bound for the United States. The following measures were recommended: 1) all adoptees examined at panel physician facilities should be screened for fever and rash illness, 2) measles immunity should be ensured among all adoptees from Henan Province who are scheduled for imminent departure to the United States, and 3) all children at the orphanage in Henan Province should be evaluated for measles. This report summarizes the results of the outbreak investigation and underscores the importance of timely routine vaccination for all international adoptees. [ABSTRACT FROM AUTHOR]

The article discusses an outbreak of measles associated with adopted children from China in Missouri, Minnesota and Washington in July 2013. According to the U.S. Centers for Disease Control & Prevention (CDC), the children experienced symptoms such as rhinorrhea, cough and rashes. Their cases were confirmed by positive immunoglobulin M (IgM) serology and polymerase chain reaction (PCR).

Objectives: To describe the epidemiology of infant pertussis in King County, Washington, and to better understand the implications for tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination among older children, adolescents, and adults. Design: Retrospective analysis of reported pertussis cases among infants younger than 1 year, January 1, 2002, through December 31, 2007. Setting: King County, Washington. Participants: Reported pertussis cases among infants younger than 1 year between 2002 and 2007. Main Outcome Measures: Bordetella pertussis from a household member or close contact was the primary exposure. The main outcome measures were age and vaccination status, incidence by race/ethnicity, suspected exposure, and Tdap eligibility of household members and close contacts. Results: Among 176 confirmed cases of infants with pertussis, the median age was 3 months (agerange,0-11months); 80.1%were younger than 6 months. Seventy-seven percent wereage-appropriately vaccinated. Between 2002 and 2007, the overall mean annual incidence was 136 cases per 100 000 infant population. Compared with amea nannual incidence of 73 cases per 100 000 infant population among whites, the incidence was 246 cases per 100 000 infant population among blacks (rate ratio [RR], 3.37;95%confidence interval [CI], 2.59-4.44) and194cases per100 000 infant population among Hispanics (RR, 2.66;95%CI, 2.02-3.53). Households were the suspected exposure location for 70.0% of cases. Case households had a median of 3 (range, 1-15) Tdap-eligible persons. Conclusions: The burden of infant pertussis in King County, Washington, was high between 2002 and 2007, especially among racial/ethnic minorities. Tdap vaccination of eligible household members and close contacts should be promoted as an additional means of protecting infants from pertussis. [ABSTRACT FROM AUTHOR]

Objective. This study evaluated risk factors for intensive care unit (ICU) admission or death among people hospitalized with 2009 pandemic influenza A (pH1N1)j virus infection. Methods. We based analyses on data collected in Washington State from April 27 ¡to September 18, 2009, on deceased or hospitalized people with laboratory-confirmed pH1N1 infection reported by health-care providers and hospitals as part of enhanced public health surveillance. We used bivariate analyses' and multivariable logistic regression, to identify risk factors associated with ICU admission or death due to pH1N1. Results.; We identified 123 patients admitted to the hospital but not an ICU and 61 patients who were admitted to an ICU or died. Independent of high- risk medical conditions, both older age and delayed time to hospital admission were identified as risk factors for ICU admission or death due to pH1N1. Specifically, the odds of ICU admission or death were 4.44 times greater among adults aged 18-49 years (95% confidence interval [CI] 1.97, 10.02) and 5.93 times greater among adults aged 50-64 years (95% CI 2.24, 15.65) compared with pédiatrie patients <18 years of age. Likewise, hospitalized cases admitted more than two days after illness onset had 2.17 times higher odds of ICU admission or death than those admitted within two days of illness onset (95% CI 1.10,;4.25). Conclusion. Although certain medical conditions clearly influence the need for hospitalizaron among people infected with pH1N1 virus, older age and delayed; time to admission each played an independent role in the progression to ICU admission or death among hospitalized patients. [ABSTRACT FROM AUTHOR]

During June-July 2015, Public Health-Seattle & King County (PHSKC) and Washington State Department of Health (WADOH) 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 United States, but is uncommon in Washington. On July 29, 2015, WADOH and PHSKC requested assistance from CDC to identify the infection source, determine risk factors, and make recommendations for prevention. [ABSTRACT FROM AUTHOR]

The article discusses the outbreak of multidrug-resistant salmonella in the U.S. It states that the confirmed case was initially identified as gastrointestinal illness with onset between April 25-September 25, 2015. It mentions that total of 192 confirmed cases were reported from several states including Washington, Oregon, and Alaska.

On March 17, 2016, Public Health-Seattle & King County in Washington was notified of two persons who received a diagnosis of Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) infections. S. zooepidemicus is a zoonotic pathogen that rarely causes human illness and is usually associated with consuming unpasteurized dairy products or with direct horse contact (1). In horses, S. zooepidemicus is a commensal bacterium that can cause respiratory, wound, and uterine infections (2). The health department investigated to determine the magnitude of the outbreak, identify risk factors, and offer recommendations. [ABSTRACT FROM AUTHOR]

The article discusses several cases wherein people got infected with Streptococcus zooepidemicus due to contact with equine. Topics discussed include case of a 37 year old woman developed mild pharyngitis and cough, a case of 71 year old woman developed symptoms consistent with an upper respiratory infection and need for research regarding risk factors for zoonotic transmission and spectrum of human illness.