26 results on '"Miko, Shanna"'
Search Results
2. Estimating Waterborne Infectious Disease Burden by Exposure Route, United States, 2014
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Gerdes, Megan E., Miko, Shanna, Kunz, Jasen M., Hannapel, Elizabeth J., Hlavsa, Michele C., Hughes, Michael J., Stuckey, Matthew J., Watkins, Louise K. Francois, Cope, Jennifer R., Yoder, Jonathan S., Hill, Vincent R., and Collier, Sarah A.
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Waterborne infections -- Statistics -- Risk factors -- Environmental aspects ,Health - Abstract
Waterborne infectious diseases substantially affect public health in the United States, despite widespread treatment and disinfection of drinking water systems and recreational water venues such as swimming pools and hot [...]
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- 2023
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- View/download PDF
3. Shiga Toxin-Producing Escherichia coli O157:H7 Illness Outbreak Associated with Untreated, Pressurized, Municipal Irrigation Water--Utah, 2023
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Osborn, BreAnne, Hatfield, Jennifer, Lanier, William, Wagner, Jennifer, Oakeson, Kelly, Casey, Ravyn, Bullough, Jacob, Kache, Pallavi, Miko, Shanna, Kunz, Jasen, Pederson, Grace, Leeper, Molly, Strockbine, Nancy, McKeel, Haley, Hofstetter, Jessica, Roundtree, Alexis, Kahler, Amy, and Mattioli, Mia
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Children -- Diseases ,Waterborne infections ,Medical research ,Medicine, Experimental ,Water ,Health - Abstract
Investigation and Results Identification of the Outbreak and Characteristics of Cases Shiga toxin-producing Escherichia coli (STEC) O157:H7 is an enteric illness that can cause hemolytic uremic syndrome (HUS), a severe, [...]
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- 2024
4. (Mis)perception and Use of Unsterile Water in Home Medical Devices, PN View 360+ Survey, United States, August 2021
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Miko, Shanna, Collier, Sarah A., Burns-Lynch, Claire E., Andujar, Ashley A., Benedict, Katharine M., Haston, Julia C., Hough, Catherine O., and Cope, Jennifer R.
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Medical equipment -- Surveys -- Usage ,Waterborne infections -- Surveys -- Risk factors ,Drinking water -- Surveys -- Usage ,Health literacy -- Surveys ,Physiological apparatus -- Surveys -- Usage ,Health - Abstract
Tap water in the United States is treated to meet safe drinking standards; however, low levels of microorganisms remain in drinking water distribution systems, wells, and premise plumbing (1,2). Although [...]
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- 2023
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5. Modifications to Sexual Behaviors Associated With Mpox (Monkeypox) Virus Transmission Among Persons Presenting for mpox Vaccination, Washington, DC, August–October, 2022
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Copen, Casey E., Delaney, Kevin P., Agnew-Brune, Christine, Berry, Isha, Griffin, Isabel, Hassan, Rashida, Oakley, Lisa P., Wondmeneh, Sarah, Rhodes, Trevor, Gillani, Sarah, Lee, Michelle, Ashley, Patrick, Willut, Christina, Mangla, Anil T., Waltenburg, Michelle A., Jackson, David A., Ahmad, Ausaf, Anthony, Eric, Argyriou, Marie, Armstrong, Jaia, Ayuk-Takor, Leslie, Brake, Marie, Bunkley, Paige, Callaway, Perri, Chakrabarti, Ayan K, Elnour, Azam, Folster, Jennifer, Forero, Catalina, Furness, Bruce (Bryce), Godino, L. Claire, Greenberg, Lauren, Guagliardo, Sarah Anne J., Israel, Dionnie, Jadhao, Samadhan, Jordan, Tekisha, Kamitani, Emiko, Keino, Barbara, Kopping, Erik, Lee, Joo, Lopez, Leah, Lowe, David, Metz, John, Meh, Ie, Miko, Shanna, Mrotz, Victoria, Notigan, Tiffany, Noiman, Adi, Partin, James, Pearce, Melissa Brykailo, Pettus, Kevin, Rajamohan, Saumya, Rodriguez, Sergio, Rowse, Julia, Sabin, Susanna, Santo, Loredana, A. Schrodt, Caroline, Shapiro, Brandon, Sharma, Pankaj, Shelus, Victoria, Shi, Dallas, Sodeke, Olutomi, Springstubb, Nora, Steppe, Jennifer, Stager, Christan Halverson, Rodriguez Stewart, Roxana, Tang, Xiaoling, Tertuliano, Moukaram, Timm, Logan, Vantucci, Casey, Widatalla, Saria, and Yang, Yong
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- 2024
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6. Mpox Knowledge, Attitudes, and Practices Among Persons Presenting for JYNNEOS Vaccination—District of Columbia, August to October 2022
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Hassan, Rashida, Wondmeneh, Sarah, Gonzalez Jimenez, Nathalie, Chapman, Kelly, Mangla, Anil, Ashley, Patrick, Willut, Christina, Lee, Michelle, Rhodes, Trevor, Gillani, Sarah, Copen, Casey, Jackson, David A., Waltenburg, Michelle, Delaney, Kevin P., Miles, Gillian, Agnew-Brune, Christine, Oakley, Lisa P., Ahmad, Ausaf, Anthony, Eric, Argyriou, Marie, Armstrong, Jaia, Ayuk-Takor, Leslie, Brake, Marie, Bunkley, Paige, Callaway, Perri, Chakrabarti, Ayan K., Elnour, Azam, Folster, Jennifer, Forero, Catalina, Furness, Bruce (Bryce), Godino, L. Claire, Greenberg, Lauren, Guagliardo, Sarah Anne J., Israel, Dionnie, Jadhao, Samadhan, Jordan, Tekisha, Kamitani, Emiko, Keino, Barbara, Kopping, Erik, Lee, Joo, Lopez, Leah, Lowe, David, Meh, Ie, Metz, John, Miko, Shanna, Mrotz, Victoria, Noiman, Adi, Notigan, Tiffany, Partin, James, Pearce, Melissa Brykailo, Pettus, Kevin, Rajamohan, Saumya, Rodriguez, Sergio, Rowse, Julia, Sabin, Susanna, Santo, Loredana, Schrodt, Caroline A., Shapiro, Brandon, Sharma, Pankaj, Shelus, Victoria, Shi, Dallas, Sodeke, Olutomi, Springstubb, Nora, Steppe, Jennifer, Halverson Stager, Christan, Rodriguez Stewart, Roxana, Tang, Xiaoling, Tertuliano, Moukaram, Timm, Logan, Vantucci, Casey, Widatalla, Saria, and Yang, Yong
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- 2024
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7. Shiga Toxin-Producing Escherichia coli O157: H7 Illness Outbreak Associated with Untreated, Pressurized, Municipal Irrigation Water -- Utah, 2023.
- Author
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Osborn, BreAnne, Hatfield, Jennifer, Lanier, William, Wagner, Jennifer, Oakeson, Kelly, Casey, Ravyn, Bullough, Jacob, Kache, Pallavi, Miko, Shanna, Kunz, Jasen, Pederson, Grace, Leeper, Molly, Strockbine, Nancy, McKeel, Haley, Hofstetter, Jessica, Roundtree, Alexis, Kahler, Amy, and Mattioli, Mia
- Subjects
ESCHERICHIA coli ,HEMOLYTIC-uremic syndrome ,PUBLIC health ,HOSPITAL care ,DISEASE outbreaks - Abstract
During July-September 2023, an outbreak of Shiga toxin-producing Escherichia coli O157:H7 illness among children in city A, Utah, caused 13 confirmed illnesses; seven patients were hospitalized, including two with hemolytic uremic syndrome. Local, state, and federal public health partners investigating the outbreak linked the illnesses to untreated, pressurized, municipal irrigation water (UPMIW) exposure in city A; 12 of 13 ill children reported playing in or drinking UPMIW. Clinical isolates were genetically highly related to one another and to environmental isolates from multiple locations within city A's UPMIW system. Microbial source tracking, a method to indicate possible contamination sources, identified birds and ruminants as potential sources of fecal contamination of UPMIW. Public health and city A officials issued multiple press releases regarding the outbreak reminding residents that UPMIW is not intended for drinking or recreation. Public education and UPMIW management and operations interventions, including assessing and mitigating potential contamination sources, covering UPMIW sources and reservoirs, indicating UPMIW lines and spigots with a designated color, and providing conspicuous signage to communicate risk and intended use might help prevent future UPMIW-associated illnesses. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Cronobacter sakazakii Infections in Two Infants Linked to Powdered Infant Formula and Breast Pump Equipment--United States, 2021 and 2022
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Haston, Julia C., Miko, Shanna, Cope, Jennifer R., McKeel, Haley, Walters, Cynney, Joseph, Lavin A., Griswold, Taylor, Katz, Lee S., Andujar, Ashley A., Tourdot, Laura, Rounds, Joshua, Vagnone, Paula, Medus, Carlota, Harris, JoAnn, Geist, Robert, Neises, Daniel, Wiggington, Ashley, Smith, Trey, Im, Monica S., Wheeler, Courtney, Smith, Peyton, Carleton, Heather A., and Lee, Christine C.
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Infant formulas ,Infection ,Control equipment ,Food contamination ,Health - Abstract
Cronobacter sakazakii, a species of gram-negative bacteria belonging to the Enterobacteriaceae family, is known to cause severe and often fatal meningitis and sepsis in young infants. C. sakazakii is ubiquitous [...]
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- 2023
9. Outbreak of Acute Gastroenteritis Among Rafters and Backpackers in the Backcountry of Grand Canyon National Park, April-June 2022
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Dale, Ariella P., Miko, Shanna, Calderwood, Laura E., King, Ronan F., Maurer, Matthew, Dyer, Laurie, Gebhardt, Marette, Maurer, Wendy, Crosby, Shawna, Wikswo, Mary E., Said, Maria A., and Mirza, Sara A.
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Social service -- Health aspects ,Medical research -- Health aspects ,Medicine, Experimental -- Health aspects ,Gastroenteritis -- Health aspects ,Ski resorts -- Health aspects ,National parks and reserves -- Health aspects ,Health - Abstract
On May 11, 2022, the National Park Service (NPS) Office of Public Health (OPH) and Coconino County Health and Human Services (CCHHS) in Flagstaff, Arizona contacted CDC about a rising [...]
- Published
- 2022
10. Public Health Actions to Control Measles Among Afghan Evacuees During Operation Allies Welcome--United States, September-November 2021
- Author
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Masters, Nina B., Mathis, Adria D., Leung, Jessica, Raines, Kelley, Clemmons, Nakia S., Miele, Kathryn, Balajee, S. Arunmozhi, Lanzieri, Tatiana M., Marin, Mona, Christensen, Deborah L., Clarke, Kevin R., Cruz, Miguel A., Gallagher, Kathleen, Gearhart, Shannon, Gertz, Alida M., Grady-Erickson, Onalee, Habrun, Caroline A., Kim, Gimin, Kinzer, Michael H., Miko, Shanna, Oberste, M. Steven, Petras, Julia K., Pieracci, Emily G., Pray, Ian W., Rosenblum, Hannah G., Ross, James M., Rothney, Erin E., Segaloff, Hannah E., Shepersky, Leah V., Skrobarcek, Kimberly A., Stadelman, Anna M., Sumner, Kelsey M., Waltenburg, Michelle A., Weinberg, Michelle, Worrell, Mary Claire, Bessette, Noelle E., Peake, Lilian R., Vogt, Marshall P., Robinson, Meredith, Westergaard, Ryan P., Griesser, Richard H., Icenogle, Joseph P., Crooke, Stephen N., Bankamp, Bettina, Stanley, Scott E., Friedrichs, Paul A., Fletcher, Larry D., Zapata, Ivan A., Wolfe, Herbert O., Gandhi, Pritesh H., Charles, Julia Y., Brown, Clive M., Cetron, Martin S., Pesik, Nicki, Knight, Nancy W., Alvarado-Ramy, Francisco, Bell, Michael, Talley, Leisel E., Rotz, Lisa D., Rota, Paul A., Sugerman, David E., and Gastanaduy, Paul A.
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United States. Department of Defense ,United States. Centers for Disease Control and Prevention ,United States. Department of Homeland Security ,United States. Air Force ,United States. Navy ,Measles ,Quarantine ,Public health ,Charter airlines ,Military bases ,Health - Abstract
On August 29, 2021, the United States government oversaw the emergent establishment of Operation Allies Welcome (OAW), led by the U.S. Department of Homeland Security (DHS) and implemented by the [...]
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- 2022
11. Gastrointestinal Illness Among Hikers on the Pacific Crest Trail--Washington, August-October 2022
- Author
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Hamlet, Arran, Begley, Katherine, Miko, Shanna, Stewart, Laurie, Tellier, Waimon, Gonzalez-De Leon, Joenice, Booth, Hillary, Lippman, Soyeon, Kahler, Amy, Roundtree, Alexis, Hatada, April, Lindquist, Scott, Melius, Beth, Goldoft, Marcia, Mattioli, Mia, and Holshue, Michelle
- Subjects
Hiking ,Gastroenteritis ,Health - Abstract
On August 26, 2022, the Washington State Department of Health received informal reports of numerous Pacific Crest Trail hikers with acute gastroenteritis (AGE). The Pacific Crest Trail stretches 2,650 miles [...]
- Published
- 2023
12. Surveillance of Waterborne Disease Outbreaks Associated with Drinking Water -- United States, 2015-2020.
- Author
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Kunz, Jasen M., Lawinger, Hannah, Miko, Shanna, Gerdes, Megan, Thuneibat, Muhammad, Hannapel, Elizabeth, and Roberts, Virginia A.
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PUBLIC health surveillance ,COMMUNICABLE diseases ,BIOFILMS ,LEGIONELLA ,WATER supply ,EPIDEMICS ,ENVIRONMENTAL exposure ,WATER pollution ,EPIDEMIOLOGICAL research ,VIRUSES ,PARASITES ,GOVERNMENT regulation - Abstract
Problem/Condition: Public health agencies in U.S. states, territories, and freely associated states investigate and voluntarily report waterborne disease outbreaks to CDC through the National Outbreak Reporting System (NORS). This report summarizes NORS drinking water outbreak epidemiologic, laboratory, and environmental data, including data for both public and private drinking water systems. The report presents outbreak-contributing factors (i.e., practices and factors that lead to outbreaks) and, for the first time, categorizes outbreaks as biofilm pathogen or enteric illness associated. Period Covered: 2015-2020. Description of System: CDC launched NORS in 2009 as a web-based platform into which public health departments voluntarily enter outbreak information. Through NORS, CDC collects reports of enteric disease outbreaks caused by bacterial, viral, parasitic, chemical, toxin, and unknown agents as well as foodborne and waterborne outbreaks of nonenteric disease. Data provided by NORS users, when known, for drinking water outbreaks include 1) the number of cases, hospitalizations, and deaths; 2) the etiologic agent (confirmed or suspected); 3) the implicated type of water system (e.g., community or individual or private); 4) the setting of exposure (e.g., hospital or health care facility; hotel, motel, lodge, or inn; or private residence); and 5) relevant epidemiologic and environmental data needed to describe the outbreak and characterize contributing factors. Results: During 2015--2020, public health officials from 28 states voluntarily reported 214 outbreaks associated with drinking water and 454 contributing factor types. The reported etiologies included 187 (87%) biofilm associated, 24 (11%) enteric illness associated, two (1%) unknown, and one (<1%) chemical or toxin. A total of 172 (80%) outbreaks were linked to water from public water systems, 22 (10%) to unknown water systems, 17 (8%) to individual or private systems, and two (0.9%) to other systems; one (0.5%) system type was not reported. Drinking water-associated outbreaks resulted in at least 2,140 cases of illness, 563 hospitalizations (26% of cases), and 88 deaths (4% of cases). Individual or private water systems were implicated in 944 (43%) cases, 52 (9%) hospitalizations, and 14 (16%) deaths. Enteric illness-associated pathogens were implicated in 1,299 (61%) of all illnesses, and 10 (2%) hospitalizations. No deaths were reported. Among these illnesses, three pathogens (norovirus, Shigella, and Campylobacter) or multiple etiologies including these pathogens resulted in 1,225 (94%) cases. The drinking water source was identified most often (n = 34; 7%) as the contributing factor in enteric disease outbreaks. When water source (e.g., groundwater) was known (n = 14), wells were identified in 13 (93%) of enteric disease outbreaks. Most biofilm-related outbreak reports implicated Legionella (n = 184; 98%); two nontuberculous mycobacteria (NTM) (1%) and one Pseudomonas (0.5%) outbreaks comprised the remaining. Legionella-associated outbreaks generally increased over the study period (14 in 2015, 31 in 2016, 30 in 2017, 34 in 2018, 33 in 2019, and 18 in 2020). The Legionella-associated outbreaks resulted in 786 (37%) of all illnesses, 544 (97%) hospitalizations, and 86 (98%) of all deaths. Legionella also was the outbreak etiology in 160 (92%) public water system outbreaks. Outbreak reports cited the premise or point of use location most frequently as the contributing factor for Legionella and other biofilm-associated pathogen outbreaks (n = 287; 63%). Legionella was reported to NORS in 2015 and 2019 as the cause of three outbreaks in private residences (2). Interpretation: The observed range of biofilm and enteric drinking water pathogen contributing factors illustrate the complexity of drinking water-related disease prevention and the need for water source-to-tap prevention strategies. Legionella-associated outbreaks have increased in number over time and were the leading cause of reported drinking water outbreaks, including hospitalizations and deaths. Enteric illness outbreaks primarily linked to wells represented approximately half the cases during this reporting period. This report enhances CDC efforts to estimate the U.S. illness and health care cost impacts of waterborne disease, which revealed that biofilm-related pathogens, NTM, and Legionella have emerged as the predominant causes of hospitalizations and deaths from waterborne- and drinking water-associated disease. Public Health Action: Public health departments, regulators, and drinking water partners can use these findings to identify emerging waterborne disease threats, guide outbreak response and prevention programs, and support drinking water regulatory efforts. [ABSTRACT FROM AUTHOR]
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- 2024
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- View/download PDF
13. Outbreak of Cryptosporidiosis Among Collegiate Swimmers and Evidence of Secondary Transmission--Massachusetts and Rhode Island, 2023
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Chiumento, Geena, Osinski, Anthony, DeVoe, Kelsey, Houghton, Amelia, Joshi, Akita, Ivanof, Caryn, Creegan, Emma, Gosciminski, Michael, Newman, Alexandra P., Madison-Antenucci, Susan, Hlavsa, Michele C., Imada, Erin, Lysen, Colleen, Miko, Shanna, Schultz, Jordan, Harvey, Emily, Vostok, Johanna, and Brown, Catherine M.
- Subjects
Swimmers ,Health - Abstract
Inadvertent ingestion of recreational waters contaminated with feces containing Cryptosporidium spp., an extremely chlorine-tolerant parasite, can result in gastrointestinal illness. In early 2023, a Massachusetts college notified the Massachusetts Department [...]
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- 2023
14. Examining Web-Based Learning to Enhance Nurse Training and the Standardization of Clinical Practice Within Complex Global Nursing Systems: A Quality Improvement Case Study.
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Schneider, Mary Beth DNP, CA, APNP, Hoffman, Sarah J., Mann, Erin, and Miko, Shanna DNP, PED-BC, CPN, CC-K
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- 2022
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15. Self-Reported Health Symptoms Following Petroleum Contamination of a Drinking Water System--Oahu, Hawaii, November 2021-February 2022
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Troeschel, Alyssa N., Gerhardstein, Ben, Poniatowski, Alex, Felton, Diana, Smith, Amanda, Surasi, Krishna, Cavanaugh, Alyson M., Miko, Shanna, Bolduc, Michele, Parasram, Vidisha, Edge, Charles, Funk, Renee, and Orr, Maureen
- Subjects
Drinking water ,Health - Abstract
In late November 2021, the Hawaii Department of Health (HDOH) received reports from Oahu residents of a fuel-like odor coming from their drinking water (1), which was later determined to [...]
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- 2022
16. Notes from the Field: Gastrointestinal Illness Among Hikers on the Pacific Crest Trail -- Washington, August--October 2022.
- Author
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Hamlet, Arran, Begley, Katherine, Miko, Shanna, Stewart, Laurie, Tellier, Waimon, Leon, Joenice Gonzalez-De, Booth, Hillary, Lippman, Soyeon, Kahler, Amy, Roundtree, Alexis, Hatada, April, Lindquist, Scott, Melius, Beth, Goldoft, Marcia, Mattioli, Mia, and Holshue, Michelle
- Subjects
GASTROENTERITIS ,SYMPTOMS ,HIKERS ,PACIFIC Crest Trail ,FATIGUE (Physiology) ,DIARRHEA - Abstract
The article discusses the cases of gastrointestinal illnesses like acute gastroenteritis (AGE) suffered by hikers at the Pacific Crest Trail in Washington and California as reported to the Washington State Department of Health in August 2022. The cases were confirmed using methods like real-time reverse transcription-polymerase chain reaction (RT-PCR). Also cited are the signs and symptoms of the disease like fatigue, vomiting, and diarrhea.
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- 2023
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17. Notes from the Field: Self-Reported Health Symptoms Following Petroleum Contamination of a Drinking Water System - Oahu, Hawaii, November 2021-February 2022.
- Author
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Troeschel, Alyssa N, Gerhardstein, Ben, Poniatowski, Alex, Felton, Diana, Smith, Amanda, Surasi, Krishna, Cavanaugh, Alyson M, Miko, Shanna, Bolduc, Michele, Parasram, Vidisha, Edge, Charles, Funk, Renée, and Orr, Maureen
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- 2022
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18. Acute Gastroenteritis Outbreak Among Colorado River Rafters and Backpackers in the Grand Canyon, 2022.
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Miko S, Calderwood L, Dale AP, King RF, Maurer MB, Said MA, Gebhardt M, Dyer LP, Maurer W, Wikswo ME, and Mirza SA
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- Humans, Adult, Middle Aged, Male, Female, Colorado epidemiology, Caliciviridae Infections epidemiology, Caliciviridae Infections transmission, Caliciviridae Infections virology, Young Adult, Risk Factors, Parks, Recreational, Aged, Swimming, Norovirus, Adolescent, Disease Outbreaks, Gastroenteritis epidemiology, Gastroenteritis virology
- Abstract
Introduction: From April 1 to May 31, 2022, Grand Canyon National Park received increased acute gastroenteritis reports. Pooled portable toilet specimens identified norovirus genogroups I and II. We sought to determine outbreak transmission contributors and individual risk factors while rafting or backpacking in the park., Methods: Grand Canyon rafters and backpackers were surveyed online from June 13-July 8, 2022, and a Cox proportional hazards model was used to identify predictors associated with illness and adjusted for potential confounding factors., Results: Among 762 surveys, 119 cases and 505 well persons submitted complete survey data. Illness among rafters was associated with interaction with ill persons during the trip (adjusted hazard ratio [adjHR] = 3.4 [95%CI 2.3-5.0]) and lack of any hand hygiene (1.2 [0.7-1.9]) or use of only sanitizer or water (1.6 [1.04-2.6]) before snacks. Younger rafters had higher illness rates compared to those ≥60 y (1.5 [1.2-1.8] for ages 40-59 and 2.2 [1.4-3.5] for ages <40 y)., Conclusions: Person-to-person transmission likely accounted for the widespread outbreak. Future outbreak mitigation efforts on river trips could focus on symptom screening before the trip starts, prompt separation of ill and well passengers, strict adherence to hand hygiene with soap and water, minimizing social interactions among rafting groups, and widespread outbreak notices and education to all park users., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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- View/download PDF
19. Shiga Toxin-Producing Escherichia coli O157:H7 Illness Outbreak Associated with Untreated, Pressurized, Municipal Irrigation Water - Utah, 2023.
- Author
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Osborn B, Hatfield J, Lanier W, Wagner J, Oakeson K, Casey R, Bullough J, Kache P, Miko S, Kunz J, Pederson G, Leeper M, Strockbine N, McKeel H, Hofstetter J, Roundtree A, Kahler A, and Mattioli M
- Subjects
- Humans, Utah epidemiology, Child, Preschool, Child, Female, Male, Infant, Adolescent, Agricultural Irrigation, Water Microbiology, Shiga-Toxigenic Escherichia coli isolation & purification, Disease Outbreaks, Escherichia coli O157 isolation & purification, Escherichia coli Infections epidemiology
- Abstract
During July-September 2023, an outbreak of Shiga toxin-producing Escherichia coli O157:H7 illness among children in city A, Utah, caused 13 confirmed illnesses; seven patients were hospitalized, including two with hemolytic uremic syndrome. Local, state, and federal public health partners investigating the outbreak linked the illnesses to untreated, pressurized, municipal irrigation water (UPMIW) exposure in city A; 12 of 13 ill children reported playing in or drinking UPMIW. Clinical isolates were genetically highly related to one another and to environmental isolates from multiple locations within city A's UPMIW system. Microbial source tracking, a method to indicate possible contamination sources, identified birds and ruminants as potential sources of fecal contamination of UPMIW. Public health and city A officials issued multiple press releases regarding the outbreak reminding residents that UPMIW is not intended for drinking or recreation. Public education and UPMIW management and operations interventions, including assessing and mitigating potential contamination sources, covering UPMIW sources and reservoirs, indicating UPMIW lines and spigots with a designated color, and providing conspicuous signage to communicate risk and intended use might help prevent future UPMIW-associated illnesses., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.
- Published
- 2024
- Full Text
- View/download PDF
20. Surveillance of Waterborne Disease Outbreaks Associated with Drinking Water - United States, 2015-2020.
- Author
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Kunz JM, Lawinger H, Miko S, Gerdes M, Thuneibat M, Hannapel E, and Roberts VA
- Subjects
- Humans, United States epidemiology, Water Microbiology, Disease Outbreaks, Water Supply, Population Surveillance, Drinking Water, Waterborne Diseases, Legionella
- Abstract
Problem/condition: Public health agencies in U.S. states, territories, and freely associated states investigate and voluntarily report waterborne disease outbreaks to CDC through the National Outbreak Reporting System (NORS). This report summarizes NORS drinking water outbreak epidemiologic, laboratory, and environmental data, including data for both public and private drinking water systems. The report presents outbreak-contributing factors (i.e., practices and factors that lead to outbreaks) and, for the first time, categorizes outbreaks as biofilm pathogen or enteric illness associated., Period Covered: 2015-2020., Description of System: CDC launched NORS in 2009 as a web-based platform into which public health departments voluntarily enter outbreak information. Through NORS, CDC collects reports of enteric disease outbreaks caused by bacterial, viral, parasitic, chemical, toxin, and unknown agents as well as foodborne and waterborne outbreaks of nonenteric disease. Data provided by NORS users, when known, for drinking water outbreaks include 1) the number of cases, hospitalizations, and deaths; 2) the etiologic agent (confirmed or suspected); 3) the implicated type of water system (e.g., community or individual or private); 4) the setting of exposure (e.g., hospital or health care facility; hotel, motel, lodge, or inn; or private residence); and 5) relevant epidemiologic and environmental data needed to describe the outbreak and characterize contributing factors., Results: During 2015-2020, public health officials from 28 states voluntarily reported 214 outbreaks associated with drinking water and 454 contributing factor types. The reported etiologies included 187 (87%) biofilm associated, 24 (11%) enteric illness associated, two (1%) unknown, and one (<1%) chemical or toxin. A total of 172 (80%) outbreaks were linked to water from public water systems, 22 (10%) to unknown water systems, 17 (8%) to individual or private systems, and two (0.9%) to other systems; one (0.5%) system type was not reported. Drinking water-associated outbreaks resulted in at least 2,140 cases of illness, 563 hospitalizations (26% of cases), and 88 deaths (4% of cases). Individual or private water systems were implicated in 944 (43%) cases, 52 (9%) hospitalizations, and 14 (16%) deaths.Enteric illness-associated pathogens were implicated in 1,299 (61%) of all illnesses, and 10 (2%) hospitalizations. No deaths were reported. Among these illnesses, three pathogens (norovirus, Shigella, and Campylobacter) or multiple etiologies including these pathogens resulted in 1,225 (94%) cases. The drinking water source was identified most often (n = 34; 7%) as the contributing factor in enteric disease outbreaks. When water source (e.g., groundwater) was known (n = 14), wells were identified in 13 (93%) of enteric disease outbreaks.Most biofilm-related outbreak reports implicated Legionella (n = 184; 98%); two nontuberculous mycobacteria (NTM) (1%) and one Pseudomonas (0.5%) outbreaks comprised the remaining. Legionella-associated outbreaks generally increased over the study period (14 in 2015, 31 in 2016, 30 in 2017, 34 in 2018, 33 in 2019, and 18 in 2020). The Legionella-associated outbreaks resulted in 786 (37%) of all illnesses, 544 (97%) hospitalizations, and 86 (98%) of all deaths. Legionella also was the outbreak etiology in 160 (92%) public water system outbreaks. Outbreak reports cited the premise or point of use location most frequently as the contributing factor for Legionella and other biofilm-associated pathogen outbreaks (n = 287; 63%). Legionella was reported to NORS in 2015 and 2019 as the cause of three outbreaks in private residences (2)., Interpretation: The observed range of biofilm and enteric drinking water pathogen contributing factors illustrate the complexity of drinking water-related disease prevention and the need for water source-to-tap prevention strategies. Legionella-associated outbreaks have increased in number over time and were the leading cause of reported drinking water outbreaks, including hospitalizations and deaths. Enteric illness outbreaks primarily linked to wells represented approximately half the cases during this reporting period. This report enhances CDC efforts to estimate the U.S. illness and health care cost impacts of waterborne disease, which revealed that biofilm-related pathogens, NTM, and Legionella have emerged as the predominant causes of hospitalizations and deaths from waterborne- and drinking water-associated disease., Public Health Action: Public health departments, regulators, and drinking water partners can use these findings to identify emerging waterborne disease threats, guide outbreak response and prevention programs, and support drinking water regulatory efforts., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.
- Published
- 2024
- Full Text
- View/download PDF
21. Community health impacts after a jet fuel leak contaminated a drinking water system: Oahu, Hawaii, November 2021.
- Author
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Miko S, Poniatowski AR, Troeschel AN, Felton DJ, Banerji S, Bolduc MLF, Bronstein AC, Cavanaugh AM, Edge C, Gates AL, Jarvis M, Mintz NA, Parasram V, Rayman J, Smith AR, Wagner JC, Gerhardstein BG, and Orr MF
- Subjects
- Child, Humans, Child, Preschool, Hawaii, Public Health, Drinking Water, Petroleum toxicity, Poisons
- Abstract
Background: In 2021, a large petroleum leak contaminated a water source that supplied drinking water to military and civilians in Oahu, Hawaii., Methods: We conducted an Assessment of Chemical Exposures (ACE) survey and supplemented that information with complementary data sources: (1) poison center caller records; (2) emergency department visit data; and (3) a key informant questionnaire., Results: Among 2,289 survey participants, 86% reported ≥1 new or worsening symptom, 75% of which lasted ≥30 days, and 37% sought medical care. Most (n = 1,653, 72%) reported new mental health symptoms. Among equally observable symptoms across age groups, proportions of children ≤2 years experiencing vomiting, runny nose, skin rashes, and coughing (33, 46, 56, and 35%, respectively) were higher than other age groups. Poison center calls increased the first 2 weeks after the contamination, while emergency department visits increased in early December 2021. Key informant interviews revealed themes of lack of support, mental health symptoms, and long-term health impact concerns., Discussion: This event led to widespread exposure to petroleum products and negatively affected thousands of people. Follow-up health surveys or interventions should give special consideration to longer-term physical and mental health, especially children due to their unique sensitivity to environmental exposures.
- Published
- 2023
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22. Notes from the Field: Outbreak of Cryptosporidiosis Among Collegiate Swimmers and Evidence of Secondary Transmission - Massachusetts and Rhode Island, 2023.
- Author
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Chiumento G, Osinski A, DeVoe K, Houghton A, Joshi A, Ivanof C, Creegan E, Gosciminski M, Newman AP, Madison-Antenucci S, Hlavsa MC, Imada E, Lysen C, Miko S, Schultz J, Harvey E, Vostok J, and Brown CM
- Subjects
- Humans, Rhode Island epidemiology, Disease Outbreaks, Massachusetts epidemiology, Cryptosporidiosis epidemiology
- Abstract
Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Catherine M. Brown reports support from the Council of State and Territorial Epidemiologists (CSTE) to attend the CSTE annual conference, and serving as chair of the CSTE Infectious Diseases Steering Committee and as an unpaid CSTE Board Member-at-Large. No other potential conflicts of interest were disclosed.
- Published
- 2023
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23. A Case of Primary Amebic Meningoencephalitis Associated with Surfing at an Artificial Surf Venue: Environmental Investigation.
- Author
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Miko S, Cope JR, Hlavsa MC, Ali IKM, Brown TW, Collins JP, Greeley RD, Kahler AM, Moore KO, Roundtree AV, Roy S, Sanders LL, Shah V, Stuteville HD, and Mattioli MC
- Abstract
Naegleria fowleri is a thermophilic ameba found in freshwater that causes primary amebic meningoencephalitis (PAM) when it enters the nose and migrates to the brain. In September 2018, a 29-year-old man died of PAM after traveling to Texas. We conducted an epidemiologic and environmental investigation to identify the water exposure associated with this PAM case. The patient's most probable water exposure occurred while surfing in an artificial surf venue. The surf venue water was not filtered or recirculated; water disinfection and water quality testing were not documented. N. fowleri and thermophilic amebae were detected in recreational water and sediment samples throughout the facility. Codes and standards for treated recreational water venues open to the public could be developed to address these novel venues. Clinicians and public health officials should also consider novel recreational water venues as a potential exposure for this rare amebic infection.
- Published
- 2023
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24. Cronobacter sakazakii Infections in Two Infants Linked to Powdered Infant Formula and Breast Pump Equipment - United States, 2021 and 2022.
- Author
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Haston JC, Miko S, Cope JR, McKeel H, Walters C, Joseph LA, Griswold T, Katz LS, Andújar AA, Tourdot L, Rounds J, Vagnone P, Medus C, Harris J, Geist R, Neises D, Wiggington A, Smith T, Im MS, Wheeler C, Smith P, Carleton HA, and Lee CC
- Subjects
- Female, Infant, Humans, Infant Formula, Enterobacteriaceae, Milk, Human, Powders, Cronobacter sakazakii genetics, Enterobacteriaceae Infections diagnosis
- Abstract
Cronobacter sakazakii, a species of gram-negative bacteria belonging to the Enterobacteriaceae family, is known to cause severe and often fatal meningitis and sepsis in young infants. C. sakazakii is ubiquitous in the environment, and most reported infant cases have been attributed to contaminated powdered infant formula (powdered formula) or breast milk that was expressed using contaminated breast pump equipment (1-3). Previous investigations of cases and outbreaks have identified C. sakazakii in opened powdered formula, breast pump parts, environmental surfaces in the home, and, rarely, in unopened powdered formula and formula manufacturing facilities (2,4-6). This report describes two infants with C. sakazakii meningitis reported to CDC in September 2021 and February 2022. CDC used whole genome sequencing (WGS) analysis to link one case to contaminated opened powdered formula from the patient's home and the other to contaminated breast pump equipment. These cases highlight the importance of expanding awareness about C. sakazakii infections in infants, safe preparation and storage of powdered formula, proper cleaning and sanitizing of breast pump equipment, and using WGS as a tool for C. sakazakii investigations., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.
- Published
- 2023
- Full Text
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25. Outbreak of Acute Gastroenteritis Among Rafters and Backpackers in the Backcountry of Grand Canyon National Park, April-June 2022.
- Author
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Dale AP, Miko S, Calderwood LE, King RF, Maurer M, Dyer L, Gebhardt M, Maurer W, Crosby S, Wikswo ME, Said MA, and Mirza SA
- Subjects
- Disease Outbreaks, Humans, Parks, Recreational, Soaps, Caliciviridae Infections epidemiology, Drinking Water, Gastroenteritis epidemiology, Gastroenteritis prevention & control, Norovirus
- Abstract
On May 11, 2022, the National Park Service (NPS) Office of Public Health (OPH) and Coconino County Health and Human Services (CCHHS) in Flagstaff, Arizona contacted CDC about a rising number of acute gastroenteritis cases among backcountry visitors to Grand Canyon National Park (Grand Canyon). The agencies reviewed illness report forms, assessed infection prevention and control (IPC) practices, and distributed a detailed survey to river rafters and hikers with backcountry permits (backpackers) who visited the Grand Canyon backcountry. During April 1-June 17, a total of 191 rafters and 31 backpackers reported symptoms consistent with acute gastroenteritis. Specimens from portable toilets used by nine river rafting trip groups were tested using real-time reverse transcription-polymerase chain reaction and test results were positive for norovirus. Norovirus-associated acute gastroenteritis is highly transmissible in settings with close person-to-person contact and decreased access to hand hygiene, such as backpacking or rafting. IPC assessments led to recommendations for regular disinfection of potable water spigots throughout the backcountry, promotion of proper handwashing with soap and water when possible, and separation of ill persons from those who are not ill. Prevention and control of acute gastroenteritis outbreaks in the backcountry requires rapid reporting of illnesses, implementing IPC guidelines for commercial outfitters and river rafting launch points, and minimizing interactions among rafting groups., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.
- Published
- 2022
- Full Text
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26. Public Health Actions to Control Measles Among Afghan Evacuees During Operation Allies Welcome - United States, September-November 2021.
- Author
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Masters NB, Mathis AD, Leung J, Raines K, Clemmons NS, Miele K, Balajee SA, Lanzieri TM, Marin M, Christensen DL, Clarke KR, Cruz MA, Gallagher K, Gearhart S, Gertz AM, Grady-Erickson O, Habrun CA, Kim G, Kinzer MH, Miko S, Oberste MS, Petras JK, Pieracci EG, Pray IW, Rosenblum HG, Ross JM, Rothney EE, Segaloff HE, Shepersky LV, Skrobarcek KA, Stadelman AM, Sumner KM, Waltenburg MA, Weinberg M, Worrell MC, Bessette NE, Peake LR, Vogt MP, Robinson M, Westergaard RP, Griesser RH, Icenogle JP, Crooke SN, Bankamp B, Stanley SE, Friedrichs PA, Fletcher LD, Zapata IA, Wolfe HO, Gandhi PH, Charles JY, Brown CM, Cetron MS, Pesik N, Knight NW, Alvarado-Ramy F, Bell M, Talley LE, Rotz LD, Rota PA, Sugerman DE, and Gastañaduy PA
- Subjects
- Disease Outbreaks prevention & control, Humans, Public Health, United States epidemiology, Vaccination, Communicable Diseases epidemiology, Measles epidemiology, Measles prevention & control
- Abstract
On August 29, 2021, the United States government oversaw the emergent establishment of Operation Allies Welcome (OAW), led by the U.S. Department of Homeland Security (DHS) and implemented by the U.S. Department of Defense (DoD) and U.S. Department of State (DoS), to safely resettle U.S. citizens and Afghan nationals from Afghanistan to the United States. Evacuees were temporarily housed at several overseas locations in Europe and Asia* before being transported via military and charter flights through two U.S. international airports, and onward to eight U.S. military bases,
† with hotel A used for isolation and quarantine of persons with or exposed to certain infectious diseases.§ On August 30, CDC issued an Epi-X notice encouraging public health officials to maintain vigilance for measles among Afghan evacuees because of an ongoing measles outbreak in Afghanistan (25,988 clinical cases reported nationwide during January-November 2021) (1) and low routine measles vaccination coverage (66% and 43% for the first and second doses, respectively, in 2020) (2)., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.- Published
- 2022
- Full Text
- View/download PDF
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