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Nontyphoidal Salmonella are consistently among the most commonly reported bacterial pathogens linked to enteric illness in Canada and the United States (1,2). In most cases, human infection is ultimately attributed [...]

Aims Methods and Results Conclusions Contact with backyard poultry (i.e., privately‐owned, non‐commercial poultry) was first associated with a multistate outbreak of salmonellosis in 1955. In recent years, backyard poultry‐associated salmonellosis outbreaks have caused more illnesses in the United States than salmonellosis outbreaks linked to any other type of animal. Here, we describe the epidemiology of outbreaks from 2015–2022 to inform prevention efforts.During 2015–2022, there were 88 multistate backyard poultry‐associated salmonellosis outbreaks and 7866 outbreak‐associated illnesses caused by 21 different Salmonella serotypes. Salmonella Enteritidis accounted for the most outbreaks (n = 21) and illnesses (n = 2400) of any serotype. Twenty‐four percent (1840/7727) of patients with available information were <5 years of age. In total, 30% (1710/5644) of patients were hospitalized, and nine deaths were attributed to Salmonella infection. Throughout this period, patients reported behaviours that have a higher risk of Salmonella transmission, including kissing or snuggling poultry or allowing poultry inside their home.Despite ongoing efforts to reduce the burden of salmonellosis associated with backyard poultry, outbreak‐associated illnesses have nearly tripled and hospitalizations more than quadrupled compared with those in 1990–2014. Because this public health problem is largely preventable, government officials, human and veterinary healthcare providers, hatcheries, and retailers might improve the prevention of illnesses by widely disseminating health and safety recommendations to the public and by continuing to develop and implement prevention measures to reduce zoonotic transmission of Salmonella by backyard poultry. [ABSTRACT FROM AUTHOR]

Enteric bacterial infections are common among people who travel internationally. During 2017–2020, the Centers for Disease Control and Prevention investigated 41 multistate outbreaks of nontyphoidal Salmonella and Shiga toxin-producing Escherichia coli linked to international travel. Resistance to one or more antimicrobial agents was detected in at least 10% of isolates in 16 of 30 (53%) nontyphoidal Salmonella outbreaks and 8 of 11 (73%) Shiga toxin-producing E. coli outbreaks evaluated by the National Antimicrobial Resistance Monitoring System. At least 10% of the isolates in 14 nontyphoidal Salmonella outbreaks conferred resistance to one or more of the clinically significant antimicrobials used in human medicine. This report describes the epidemiology and antimicrobial resistance patterns of these travel-associated multistate outbreaks. Investigating illnesses among returned travellers and collaboration with international partners could result in the implementation of public health interventions to improve hygiene practices and food safety standards and to prevent illness and spread of multidrug-resistant organisms domestically and internationally. [ABSTRACT FROM AUTHOR]

Multidrug-resistant organisms (MDROs) are well-known concerns in human healthcare, but less is known about them in animal populations. When a New Delhi Metallo-beta-lactamase producing Escherichia coli (CP-CRE), was identified at an animal rescue facility (ARF), a multidisciplinary team consisting of veterinary, public health, and infection prevention professionals responded to prevent further transmission and strengthen infection prevention and control (IPC). After the initial identification, public health authorities collaborated with the ARF and associated veterinary clinics to determine the MDRO transmission risk within the facilities and to the surrounding community based on current practices. Focused IPC observations were completed to evaluate practices and identify possible transmission routes. Many challenges were identified, including high population density, suboptimal environmental cleaning, limited space for animal isolation, and no separation between human and animal spaces. The ARF had few IPC procedures built into the care of these high-risk animals, some of which had countries of origin where CP-CRE is endemic. Associated veterinary locations were found to incorporate some IPC practices in their daily routines. Public health staff educated facilities' staff on a variety of IPC topics, including hand hygiene, use of personal protective equipment, and cleaning and disinfection methods, so better IPC practices could be incorporated into the daily routines at the ARF and veterinary facilities. Findings from this outbreak suggest lack of regular IPC practices may contribute to novel MDRO transmission within animal care settings, across human and animal settings, and to the public in the surrounding communities. Veterinarians should be included in discussions given the One Health implications of antibiotic resistance, including updating standards to jointly keep animals, people, and the environment safe from increasing MDRO concerns. A multidisciplinary team to bridge human and animal health can help reduce MDRO transmission risks by building MDRO foundational knowledge and tailoring IPC practices in affected facilities. [ABSTRACT FROM AUTHOR]

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.

Trypanosoma cruzi -associated megaesophagus was diagnosed in a domestic Louisiana-born llama with no significant travel history. The llama resided in the same rural area of greater New Orleans, Louisiana, where the first human autochthonous case of Chagas disease was identified in the state. Venous blood from the llama tested positive for T. cruzi kinetoplastid DNA by conventional PCR. The cardiac evaluation was unremarkable, while thoracic radiographs revealed generalized megaesophagus. The llama received supportive care, but was ultimately humanely euthanized. The esophagus was severely distended throughout its length on necropsy, and histologic evaluation showed no microscopic changes in esophageal tissue and minimal to mild lymphoplasmacytic inflammation in cardiac tissue. T. cruzi DNA was detected by conventional PCR in the esophagus, small intestine, and blood despite no protozoan organisms being observed in multiple tissue sections examined. This report contributes to the growing body of evidence of local transmission of T. cruzi in the southern United States, and Chagas disease should be considered a differential diagnosis when evaluating llamas and other large animal species for esophageal dysfunction. There is little research describing megaesophagus or Chagas disease in llamas, and this report aims to increase awareness about this zoonotic disease that is becoming more frequently reported in the southern United States.