Search

Peruvian veterinarians and animal care workers (VACW) are primary responders in the event of disasters or emergencies, yet they face unique concerns that could impede or block their essential functions in public health preparedness in comparison with VACWs in other countries. In this study, we used the Ready, Willing, and Able model via electronic survey to evaluate the perception of risks and barriers that Peruvian VACWs faced when deciding whether to continue working during the COVID-19 pandemic between July and December 2020. We used logistic regression models to evaluate associations between demographic characteristics, perceived role, and contact scores with 8 outcomes: knowledge of COVID-19; confidence in safety protocols; perceived threat; perceived job efficacy; perceived barriers; and readiness, willingness, and ability to respond to the COVID-19 pandemic. Less than 50% of respondents reported barriers to report to work during the pandemic. Respondents who reported higher contact with coworkers had an increased confidence in safety protocols (OR 5.16; 95% CI, 1.36 to 19.61) and willingness (OR 3.76; 95% CI, 1.14 to 12.47) to respond to the pandemic. Close contacts with essential workers and higher economic income were associated with higher reported knowledge of COVID-19. Respondents with higher perceived job efficacy had higher odds of reporting being ready, willing, and able to respond to COVID-19, while those who identified more barriers to report to work had lower odds of being ready, willing, and able to respond. The findings from this study, which showed differences from VACWs in the United States, can be used by individuals designing programs to improve pandemic and disaster preparedness in this essential, yet understudied and vulnerable, workforce.

To determine if the addition of home environmental control strategies (ECSs) to controller medication titration reduces asthma controller medication requirements and in-home allergen concentrations among children with persistent asthma in Baltimore City. 155 children ages 5–17 with allergen-sensitized asthma were enrolled in a 6-month randomized clinical trial of multifaceted, individually-tailored ECS plus asthma controller medication titration compared to controller medication titration alone. Participants had to meet criteria for persistent asthma and have had an exacerbation in the previous 18 months. Allergen sensitization (mouse, cockroach, cat, dog, dust mite) was assessed at baseline and home dust allergen concentrations were measured at baseline, 3 and 6 months. ECS was delivered 3–4 times over the trial. Asthma controller medication was titrated using a guidelines-based algorithm at baseline, 2, 4, and 6 months. The primary outcome was controller medication treatment step at 6 months (0–6, as-needed albuterol to high-dose ICS + LABA). The population was predominately Black (90%), on public insurance (93%), and male (61%). The mean age was 10.1 years (SD 3.3). More than 70% were sensitized to a rodent, >50% to cockroach, and 70% were polysensitized. At 6 months, there were no differences in either treatment step (3.8 [SD 1.4] vs. 3.7 [SD 1.5]) or allergen concentrations between groups. Among this predominantly low-income, Black pediatric asthma population, the addition of ECS to controller medication titration reduced neither indoor allergen concentrations nor controller medication requirements compared to controller medication titration alone.

Rationale: Indoor particulate matter is associated with worse COPD outcomes. It remains unknown whether reductions of indoor pollutants improve respiratory morbidity. Methods: Eligible former smoke...

Rationale Environmental exposures have been associated with adverse outcomes in COPD. Approximately one third of individuals with COPD have allergic sensitization, but it is unknown whether exposure to allergens in the home are associated with outcomes. Objectives To determine the prevalence and associations of allergen sensitization with exposure to common indoor allergens with symptoms and exacerbation risk in COPD. Methods Allergen sensitization to five common indoor allergens was assessed in former smokers with COPD. Home settled dust was assessed for presence of corresponding allergens. Sensitization and exposure status were determined and associations evaluated in adjusted models with longitudinal outcomes including symptoms, lung function and exacerbations. Interactions were assessed between sensitization/exposure status and lung function. Measurements and Main Results One hundred eighty-three individuals studied were on average 67.3 years old (SD 8.22) with average FEV1 of 53.2 % (SD 17.6%). Seventy-seven percent of participants were exposed to at least one tested allergen, and 17% had sensitization with corresponding allergen exposure. After adjustment, sensitization with exposure was associated with lower lung function (β -8.29, 95% CI -14.80 to -1.77), higher SGRQ (β 6.71, 95% CI 0.17 to 13.25) and higher exacerbation risk (OR 2.31, 95% CI 1.11 to 4.79). Associations appeared to be more pronounced among individuals with lower lung function. Conclusions Allergen exposures are common in COPD and associated with adverse outcomes among those with concomitant allergen sensitization. This study establishes allergens as an important home exposure that potentially could be addressed with comprehensive home environmental modification strategies to improve COPD outcomes.

BACKGROUND Overuse of antibiotics contributes to antimicrobial resistance (AMR) and is a growing threat to human health worldwide. Previous work suggests a link between antimicrobial use in poultry and human AMR extraintestinal pathogenic Escherichia coli (E coli) urinary tract infections (UTIs). However, few US-based studies exist, and none have comprehensively assessed both foodborne and environmental pathways using advanced molecular and spatial epidemiologic methods in a quasi-experimental design. Recently, California enacted Senate Bill 27 (SB27), which changed previous policy to require a veterinarian’s prescription for the use of antibiotic drugs, and which banned antibiotic use for disease prevention in livestock. This provided an opportunity to evaluate whether SB27 will result in a reduction in antimicrobial-resistant infections in humans. OBJECTIVE We describe in detail the methods implemented to achieve the overarching objective of this study to evaluate the impact of SB27 on downstream antibiotic resistance rates in human UTIs. METHODS A summary of the overall approach and the partnerships between Columbia University, George Washington University (GWU), Johns Hopkins Bloomberg School of Public Health, Kaiser Permanente Southern California (KPSC) Research and Evaluation, the Natural Resources Defense Council, Sanger Institute at Stanford University, Sutter Health Center for Health Systems Research, the University of Cambridge, and the University of Oxford is presented. The collection, quality control testing, and shipment of retail meat and clinical samples are described. Retail meat (chicken, beef, turkey, and pork) was purchased from stores throughout Southern California from 2017 to 2021. After processing at KPSC, it was shipped to GWU for testing. From 2016 to 2021, after clinical specimens were processed for routine clinical purposes and immediately before discarding, those with isolated colonies of E coli, Campylobacter, and Salmonella from KPSC members were collected and processed to be shipped for testing at GWU. Detailed methods of the isolation and testing as well as the whole-genome sequencing of the meat and clinical samples at GWU are described. KPSC electronic health record data were used to track UTI cases and AMR patterns among the cultured specimens. Similarly, Sutter Health electronic health record data were used to track UTI cases in its Northern California patient population. RESULTS From 2017 to 2021, overall, 12,616 retail meat samples were purchased from 472 unique stores across Southern California. In addition, 31,643 positive clinical cultures were collected from KPSC members during the same study period. CONCLUSIONS Here, we presented data collection methods for the study, which was conducted to evaluate the impact of SB27 on downstream antibiotic resistance rates in human UTI. To date, it is one of the largest studies of its kind to be conducted. The data collected during this study will be used as the foundation for future analyses specific to the various objectives of this large body of work. CLINICALTRIAL INTERNATIONAL REGISTERED REPORT DERR1-10.2196/45109

Introduction Occupational activities related to industrial hog operation (IHO) worker lung function are not well defined. Therefore, we aimed to identify IHO work activities associated with diminished respiratory function and the effectiveness, if any, of personal protective equipment (PPE) use on IHOs. Methods From 2014 to 2015, 103 IHO workers were enrolled and followed for 16 weeks. At each biweekly visit, work activities and PPE use were self-reported via questionnaire and lung function measurements were collected via spirometry. Generalized linear and linear fixed-effects models were fitted to cross-sectional and longitudinal data. Results Increasing years worked on an IHO were associated with diminished lung function, but baseline and longitudinal work activities were largely inconsistent in direction and magnitude. Unexpectedly, a -0.3 L (95% confidence interval: -0.6, -0.04) difference in forced expiratory volume in the first second (FEV1 ) was estimated when workers wore PPE consistently (≥80% of the time at work) versus those weeks they did not. In post-hoc analyses, we found that coveralls and facemasks were worn less consistently when workers experienced worse barn conditions and had more contact with pigs, but coveralls were worn more consistently as cleaning activities increased. Conclusions Similar to past studies, baseline estimates were likely obscured by healthy worker effect bias, but showed decrements in worker lung function as years of work increased. A challenge to disentangling the effect of work activities on lung function was the discovery that IHO workers used PPE differently according to the work task. These data suggest that interventions may be targeted toward improving barn conditions so that workers can consistently utilize IHO-provided PPE.

BACKGROUND: Animal-assisted intervention (AAI) programs, used widely for patient benefit, have increasingly been used for healthcare workers (HCW) to reduce occupational stress. However, there are barriers to these programs which limit their utilization, for both patients and HCW, specifically infectious disease concerns. The aim of the research project is to identify barriers and facilitators to AAI program use for healthcare worker benefit, and determine knowledge, beliefs, and practices regarding infectious disease risk and control policies, in order to understand the contextual parameters of program implementation. METHODS: We collected perceptions of key stakeholders involved with hospital AAI programs (HCW and AAI workers) through semi-structured in-depth interviews. We used framework analysis to guide thematic coding, completed independently by three researchers. RESULTS: We interviewed 37 participants in this study. We divided our themes into two topic areas: program use for HCW and perceived infectious disease risk. Use for healthcare workers included perspectives on the benefits for HCW and program barriers and facilitators (specifically collaboration and leadership). Perceived risk included opinions on infection concerns with AAI, thoughts on control measures to reduce this risk, and responsibility for safety during these programs. CONCLUSIONS: While significant benefits were reported for HCW, they were limited by administrative barriers and hazard concerns. Facilitators to surmount these barriers are best implemented with collaboration across the hospital and appropriate leadership roles to direct safe program implementation. By addressing these barriers through targeted facilitators in the form of evidence-backed guidelines, AAI programs can be used to benefit both patients and HCW.

Transmission of livestock-associated Staphylococcus aureus clonal complex 9 (LA-SA CC9) between pigs raised on industrial hog operations (IHOs) and humans in the United States is poorly understood. We analyzed whole-genome sequences from 32 international S. aureus CC9 isolates and 49 LA-SA CC9 isolates from IHO pigs and humans who work on or live near IHOs in 10 pig-producing counties in North Carolina, USA. Bioinformatic analysis of sequence data from the 81 isolates demonstrated 3 major LA-SA CC9 clades. North Carolina isolates all fell within a single clade (C3). High-resolution phylogenetic analysis of C3 revealed 2 subclades of intermingled IHO pig and human isolates differing by 0–34 single-nucleotide polymorphisms. Our findings suggest that LA-SA CC9 from pigs and humans share a common source and provide evidence of transmission of antimicrobial-resistant LA-SA CC9 between IHO pigs and humans who work on or live near IHOs in North Carolina.

ImportanceStructural racism has been implicated in the disproportionally high asthma morbidity experienced by children living in disadvantaged, urban neighborhoods. Current approaches designed to reduce asthma triggers have modest impact.ObjectiveTo examine whether participation in a housing mobility program that provided housing vouchers and assistance moving to low-poverty neighborhoods was associated with reduced asthma morbidity among children and to explore potential mediating factors.Design, Setting, and ParticipantsCohort study of 123 children aged 5 to 17 years with persistent asthma whose families participated in the Baltimore Regional Housing Partnership housing mobility program from 2016 to 2020. Children were matched to 115 children enrolled in the Urban Environment and Childhood Asthma (URECA) birth cohort using propensity scores.ExposureMoving to a low-poverty neighborhood.Main OutcomesCaregiver-reported asthma exacerbations and symptoms.ResultsAmong 123 children enrolled in the program, median age was 8.4 years, 58 (47.2%) were female, and 120 (97.6%) were Black. Prior to moving, 89 of 110 children (81%) lived in a high-poverty census tract (>20% of families below the poverty line); after moving, only 1 of 106 children with after-move data (0.9%) lived in a high-poverty tract. Among this cohort, 15.1% (SD, 35.8) had at least 1 exacerbation per 3-month period prior to moving vs 8.5% (SD, 28.0) after moving, an adjusted difference of −6.8 percentage points (95% CI, −11.9% to −1.7%; P = .009). Maximum symptom days in the past 2 weeks were 5.1 (SD, 5.0) before moving and 2.7 (SD, 3.8) after moving, an adjusted difference of −2.37 days (95% CI, −3.14 to −1.59; P Conclusions and RelevanceChildren with asthma whose families participated in a program that helped them move into low-poverty neighborhoods experienced significant improvements in asthma symptom days and exacerbations. This study adds to the limited evidence suggesting that programs to counter housing discrimination can reduce childhood asthma morbidity.

Domestic cats, an important companion animal, can be infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This has aroused concern regarding the ability of domestic cats to spread the virus that causes coronavirus disease 2019. We systematically demonstrated the pathogenesis and transmissibility of SARS-CoV-2 in cats. Serial passaging of the virus between cats dramatically attenuated the viral transmissibility, likely owing to variations of the amino acids in the receptor-binding domain sites of angiotensin-converting enzyme 2 between humans and cats. These findings provide insight into the transmissibility of SARS-CoV-2 in cats and provide information for protecting the health of humans and cats. Article Summary Line: Domestic cats are susceptible to SARS-CoV-2 and have attenuated transmissibility after serial passaging.

Humans, animals, and the environment face a universal crisis: antimicrobial resistance (AR). Addressing AR and its multi-disciplinary causes across many sectors including in human and veterinary medicine remains underdeveloped. One barrier to AR efforts is an inconsistent process to incorporate the plenitude of stakeholders about what AR is and how to stifle its development and spread—especially stakeholders from the animal agriculture sector, one of the largest purchasers of antimicrobial drugs. In 2019, The Wellcome Trust released Reframing Resistance: How to communicate about antimicrobial resistance effectively (Reframing Resistance), which proposed the need to establish a consistent and harmonized messaging effort that describes the AR crisis and its global implications for health and wellbeing across all stakeholders. Yet, Reframing Resistance does not specifically engage the animal agriculture community. This study investigates the gap between two principles recommended by Reframing Resistance and animal agriculture stakeholders. For this analysis, the research group conducted 31 semi-structured interviews with a diverse group of United States animal agriculture stakeholders. Participants reported attitudes, beliefs, and practices about a variety of issues, including how they defined AR and what entities the AR crisis impacts most. Exploration of Reframing Resistance’s Principle 2, “explain the fundamentals succinctly” and Principle 3, “emphasis that this is universal issue; it can affect anyone, including you” reveals disagreement in both the fundamentals of AR and consensus of “who” the AR crisis impacts. Principle 2 may do better to acknowledge that animal agriculture stakeholders espouse a complex array of perspectives that cannot be summed up in a single perspective or principle. As a primary tool to combat AR, behavior change must be accomplished first through outreach to stakeholder groups and understanding their perspectives.

The use of nontherapeutic broad-spectrum antimicrobial agents triclosan (TCS) and benzalkonium chloride (BC) can contribute to bacterial resistance to clinically relevant antibiotics. Antimicrobial-resistant bacteria within wastewater may reflect the resistance burden within the human microbiome, as antibiotics and pathogens in wastewater can track with clinically relevant parameters during perturbations to the community. In this study, we monitored culturable and resistant wastewater bacteria and cross-resistance to clinically relevant antibiotics to gauge the impact of each antimicrobial and identify factors influencing cross-resistance profiles. Bacteria resistant to TCS and BC were isolated from wastewater influent over 21 months, and cross-resistance, taxonomy, and monthly changes were characterized under both antimicrobial selection regimes. Cross-resistance profiles from each antimicrobial differed within and between taxa. BC-isolated bacteria had a significantly higher prevalence of resistance to "last-resort antibiotic" colistin, while isolates resistant to TCS exhibited higher rates of multidrug resistance. Prevalence of culturable TCS-resistant bacteria decreased over time following Food and Drug Administration (FDA) TCS bans. Cross-resistance patterns varied according to sampling date, including among the most clinically important antibiotics. Correlations between strain-specific resistance profiles were largely influenced by taxonomy, with some variations associated with sampling date. The results reveal that time, taxonomy, and selection by TCS and BC impact features of cross-resistance patterns among diverse wastewater microorganisms, which could reflect the variety of factors influencing resistance patterns relevant to a community microbiome.

To determine whether school infrastructure is associated with health and academic outcomes among elementary school children with asthma.We conducted a retrospective cohort study of linked medical, academic, and facilities data from a large mid-Atlantic school district of the United States. All K-5 students with asthma who were enrolled under the state's Children's Health Insurance Program were included. We estimated associations of the infrastructure quality of the student's school, as assessed by an engineering firm in Summer 2011 and represented by the Facility Condition Index (FCI), with asthma health outcomes, absenteeism, and standardized test scores in math and reading in the two academic years thereafter.6,558 students were identified, the majority non-Hispanic Black, across 130 schools. Most schools (97/130, 75%) were in very poor or worse condition. In cluster-adjusted models accounting for demographics, grade, school-specific area deprivation, and inhaled corticosteroid use, a one standard deviation increase in FCI, corresponding to greater infrastructure deficiency, was associated with higher rates of asthma-related hospitalizations (incidence rate ratio [IRR] 1.16; 95% confidence interval [CI] 1.03, 1.32), more absenteeism (IRR 1.05; 95% CI 1.01, 1.08), and lower scores in math (mean difference [MD] -3.3; 95% CI -5.5, -1.2) and reading (MD -3.0; 95% CI -5.1, -0.9). There were no differences in rates of asthma-related emergency visits or steroid prescriptions.Children with asthma attending schools with poorer infrastructure had worse health and academic outcomes. Public policy emphasizing reinvestment in school infrastructure may be a potential means of addressing asthma disparities.

Low-wage service sector jobs are largely occupied by racial/ethnic minority workers who often experience an increased risk of elevated chemical exposures, including chemicals like phthalates, compared to the general public. Phthalates have been linked with adverse health effects, including increased risk of atopy and asthma. An important etiological component in respiratory disease, including asthma, is the role of the upper respiratory microbiota in atopic disease development. However, it is unclear how the upper respiratory microbiome is affected by chemical exposures, and how this may impact respiratory outcomes. As Latino workers are often disproportionately exposed to increased concentrations of chemicals and Hispanics have higher rates of adverse respiratory health conditions such as asthma, the aim of this pilot study was to evaluate the effects of 10 unique phthalate urinary biomarkers on the 16S rRNA nasal microbiome. Nasal and urinary samples were collected from 20 facility workers (plumbers, landscapers, electricians) and 20 custodial workers. Our analysis revealed altered microbial composition and diversity according to phthalate urinary biomarker concentration within the two worker groups. Higher urinary biomarker concentrations of select phthalates (MBP, MBIP, and ∑DEHP) were associated with increased Moraxella relative abundance, which has been positively associated with asthma. Within-sample alpha diversity levels were decreased in facility workers and were generally inversely associated with most phthalate urinary biomarker concentrations. Our research suggests that exposure to chemicals in this vulnerable worker group may impact the respiratory microbiome, which may increase risk of development of adverse health conditions. Further research is warranted to refine the mechanistic pathways that underpin the relationships between phthalate exposures and respiratory microbial communities to provide key insights on respiratory pathologies and, most importantly, to identify modifiable risk factors that can be used to direct mitigation efforts aimed at ameliorating the harmful effects of chemical exposures in this understudied occupational population.

Recent advances in molecular source tracking make answering questions from residents regarding their exposure to microbial contaminants from industrial hog operations (IHOs) possible. Associations between residential distance to IHOs and exposure can be addressed by measuring livestock-associated (Staphylococcus aureus) and pig-specific bacteria in the air, on household surfaces, and in participants' nasal and saliva swabs.Here we assess the mechanics, feasibility, capacity-building, and lessons learned during a pilot study employing this novel technology in community-based participatory research of bacterial exposure and human health.Together, our team of academics and community members designed a field- and laboratory-based pilot study. Air samples, surface and human swabs, and questionnaires from households at varying distances from IHOs were collected. Data were assessed for completeness and quality by two independent reviewers. These metrics were defined as: missingness (completeness), incorrect data type (validity), out of range (validity), and outliers (accuracy).While critical field equipment was obtained, and knowledge exchange occurred, leading to an increased capacity for future work, after review, 38 of 49 households were deemed eligible for inclusion in the study. Of eligible participants, 98% of required electronic survey questions were complete and 100% were valid; an improvement over prior work which employed paper surveys. While all human microbial and air samples were collected from eligible households (n = 231), (5%) of environmental swabs were reported missing.Using community-appropriate sampling protocols, a pilot study of residential exposure to bacteria from IHOs was completed. While high-quality data was collected from those eligible, we learned the necessity of early and continual data review.

Industrial food animal production accounts for most animal-source protein consumed in the USA. These operations rely on an array of external inputs, which can include antimicrobials of medical importance. The use of these drugs in this context has been the subject of public health debate for decades because their widespread use contributes to the selection for and proliferation of drug-resistant bacteria and their genetic determinants. Here, we describe legislative and regulatory efforts, at different levels of governance in the USA, to curtail food animal consumption of medically important antimicrobials.The features and relative success of the US efforts are examined alongside those of selected member states (Denmark and the Netherlands) of the European Union. Evaluation of efforts at all levels of US governance was complicated by shortcomings in prescribed data collection; nevertheless, available information suggests deficiencies in policy implementation and enforcement compromise the effectiveness of interventions pursued to date. The political will, robust systems for collecting and integrating data on antimicrobial consumption and use, and cross-sectoral collaboration that have been integral to the success of efforts in Denmark and The Netherlands have been notably absent in the USA, especially at the federal level.

Despite improvements in hospital infection prevention and control, healthcare associated infections (HAIs) remain a challenge with significant patient morbidity, mortality, and cost for the healthcare system. In this review, we use a One Health framework (human, animal, and environmental health) to explain the epidemiology, demonstrate key knowledge gaps in infection prevention policy, and explore improvements to control Gram-positive pathogens in the healthcare environment. We discuss patient and healthcare worker interactions with the hospital environment that can lead to transmission of the most common Gram-positive hospital pathogens – methicillin-resistant Staphylococcus aureus, Clostridioides (Clostridium) difficile, and vancomycin-resistant Enterococcus – and detail interventions that target these two One Health domains. We discuss the role of animals in the healthcare settings, knowledge gaps regarding their role in pathogen transmission, and the absence of infection risk mitigation strategies targeting animals. We advocate for novel infection prevention and control programs, founded on the pillars of One Health, to reduce Gram-positive hospital-associated pathogen transmission.

Antimicrobial use (AMU) in animal agriculture contributes to antimicrobial resistance (AMR) in humans, which imposes significant health and economic costs on society. Economists call these costs negative externalities, societal costs that are not properly reflected in market prices. We review the relevant literature and develop a model to quantify the external costs of AMU in animal agriculture on AMR in humans. Parameters required for this estimate include ( a) the health and economic burden of AMR in humans,( b) the impact of AMU in animal agriculture on AMR in animals, ( c) the fraction of AMR in humans attributable to animal agriculture, and ( d) AMU in animals. We use a well-documented historic case to estimate an externality cost of about US$1,500 per kilogram of fluoroquinolones administered in US broiler chicken production. Enhanced data collection, particularly on the third and fourth parameters, is urgently needed to quantify more fully the externalities of AMU in animal agriculture.

It has been suggested that pets play a critical role in the maintenance of methicillin-resistant (MR) and multidrug-resistant (MDR) Staphylococcus spp. in the household. We examined risk factors for carriage of antimicrobial-resistant coagulase-positive staphylococci, with particular attention to Staphylococcus aureus and Staphylococcus pseudintermedius isolated from pets living in households of people diagnosed with methicillin-resistant S. aureus (MRSA) skin or soft-tissue infection. We analyzed data collected cross-sectionally from a study conducted in 2012 that evaluated the transmission of MRSA and other staphylococci from humans, their pets and the environment (Pets and Environmental Transmission of Staphylococci [PETS] study). We used unadjusted and adjusted stratified logistic regression analyses with household-clustered standard errors to evaluate the association between demographic, healthcare-related, contact-related and environmental risk factors and MDR Staphylococcus spp. isolated from dogs and cats. Staphylococcal isolates obtained from dogs (n = 63) and cats (n = 47) were included in these analyses. The use of oral or injectable antimicrobials by the pets during the prior year was the main risk factor of interest. Based on our results, 50% (12/24) of S. aureus, 3.3% (1/30) of S. pseudintermedius and 25% (14/56) of other coagulase-positive staphylococci (CPS) were determined to be MDR. S. aureus isolates were more likely to be MDR compared with S. pseudintermedius. We did not find a significant statistical association between the use of oral or injectable antimicrobials in the prior year and the presence of MDR bacteria. The results suggest that drivers of antimicrobial resistance in household staphylococci may vary by bacterial species, which could have implications for one health intervention strategies for staphylococci and inform the investigation of other reverse zoonoses, such as COVID-19.

Household pets can carry meticillin-resistant Staphylococcus aureus (MRSA) introduced to the home by their human companions. Specific factors promoting pet carriage of this pathogen have not been fully elucidated.This study evaluated MRSA cultured from pets and the home environment in households where a human infected with MRSA had been identified, and aimed to determine potential risk factors for pet MRSA carriage.Humans diagnosed with community-associated MRSA (CA-MRSA) skin or soft-tissue infection (SSTI) in the mid-Atlantic United States were identified. One hundred forty-two dogs and cats from 57 affected households were identified of which 134 (94.4%) pets and the household environment were sampled for bacterial culture, PCR confirmation and spa-typing for MRSA strain determination. Samples were obtained 3 months later from 86 pets.At baseline, 12 (9.0%) pets carried MRSA. Potential risk factors associated with carriage included pet bed (environmental) MRSA contamination, flea infestation and prior antimicrobial use in the pet. Pets tended to carry human-adapted MRSA strains and spa-types of MRSA isolates cultured from pets were concordant with strains cultured from the home environment in seven of eight homes (87.5%) at baseline.Results may inform risk-based veterinary clinical recommendations and provide evidence for selective pet testing as a possible alternative to early removal of pets from the homes of humans infected with MRSA. MRSA contamination of the home environment is likely an important risk factor for pet MRSA carriage, and household interventions should be considered to reduce risk of MRSA carriage in exposed pets.Les animaux domestiques peuvent être porteurs de Staphylococcus aureus résistant à la méticilline (SARM) introduit à la maison par leurs compagnons humains. Les facteurs spécifiques favorisant le portage de cet agent pathogène par les animaux de compagnie n'ont pas été entièrement élucidés.Cette étude a évalué le SARM cultivé à partir d'animaux de compagnie et de l'environnement domestique dans des ménages où une infection humaine à SARM avait été identifiée, et visait à déterminer les facteurs de risque potentiels de portage du SARM par les animaux de compagnie. MATÉRIELS ET MÉTHODES: Les humains diagnostiqués avec une infection de la peau ou des tissus mous (SSTI) à SARM d'origine communautaire (CA-MRSA) dans le centre de l'Atlantique aux États-Unis ont été identifiés. Cent quarante-deux chiens et chats de 57 foyers touchés ont été identifiés, dont 134 (94,4 %) animaux de compagnie et l'environnement domestique ont été échantillonnés pour la culture bactérienne, la confirmation par PCR et le typage spa pour la détermination de la souche de SARM. Des échantillons ont été prélevés trois mois plus tard sur 86 animaux de compagnie. RÉSULTATS: Au départ, 12 (9,0 %) animaux de compagnie étaient porteurs du SARM. Les facteurs de risques potentiels associés au portage comprenaient la contamination (environnementale) du lit de l'animal par le SARM, l'infestation par les puces et l'utilisation antérieure d'antimicrobiens chez l'animal. Les animaux de compagnie avaient tendance à être porteurs de souches de SARM adaptées à l'homme et les isolats de SARM de type spa cultivés à partir d'animaux de compagnie étaient concordants avec les souches cultivées à partir de l'environnement domestique dans sept des huit foyers (87,5 %) au départ.Les résultats peuvent éclairer les recommandations cliniques vétérinaires fondées sur les risques et fournir des preuves pour le dépistage sélectif des animaux de compagnie comme alternative possible au retrait précoce des animaux de compagnie des maisons des humains infectés par le SARM. La contamination par le SARM de l'environnement domestique est probablement un facteur de risque important pour le portage du SARM chez les animaux de compagnie, et des interventions domestiques doivent être envisagées pour réduire le risque de portage du SARM chez les animaux de compagnie exposés.INTRODUCCIÓN: las mascotas domésticas pueden portar Staphylococcus aureus resistente a la meticilina (MRSA) introducido en el hogar por sus compañeros humanos. Los factores específicos que promueven que las mascotas sean portadoras de este patógeno no se han dilucidado por completo. OBJETIVO: este estudio evaluó bacterias MRSA cultivadas de mascotas y del medio ambiente en hogares donde se identificó una infección humana por MRSA, y tuvo como objetivo determinar los factores de riesgo potenciales para el transporte de MRSA en mascotas. MATERIALES Y MÉTODOS: se identificaron humanos diagnosticados con infección de piel o tejidos blandos (SSTI) por MRSA comunitario (CA-MRSA) en la zona del Atlántico medio de los Estados Unidos. Se identificaron 142 perros y gatos de 57 hogares afectados, de los cuales se tomaron muestras de 134 (94,4 %) mascotas y del entorno del hogar para cultivo bacteriano, confirmación por PCR y tipificación por spa para determinar la cepa de MRSA. Se obtuvieron muestras tres meses después de 86 mascotas. RESULTADOS: al inicio del estudio, 12 (9,0 %) mascotas portaban MRSA. Los factores de riesgo potenciales asociados con el transporte incluyeron la cama de la mascota (ambiental), la contaminación por MRSA, la infestación por pulgas y el uso previo de antimicrobianos en la mascota. Las mascotas tendían a ser portadoras de cepas de MRSA adaptadas a humanos y los tipos de spa de aislados de MRSA cultivados a partir de mascotas coincidían con las cepas cultivadas del entorno doméstico en siete de ocho hogares (87,5 %) al inicio del estudio. CONCLUSIONES Y RELEVANCIA CLÍNICA: los resultados pueden aportar recomendaciones clínicas veterinarias basadas en el riesgo y proporcionar evidencia para pruebas selectivas en mascotas como una posible alternativa a la eliminación temprana de mascotas de los hogares de humanos infectados con MRSA. La contaminación de MRSA en el entorno del hogar probablemente sea un factor de riesgo importante para el transporte de MRSA en mascotas, y se deben considerar intervenciones domésticas para reducir el riesgo de transporte de MRSA en mascotas expuestas.Haustiere können einen Methicillin-resistenten Staphylococcus aureus (MRSA) tragen, welcher durch die menschlichen Gefährten in den Haushalt gebracht wurde. Bisher wurden spezifische Faktoren, die dieses Tragen der Pathogene durch die Haustiere fördern, noch nicht vollständig untersucht. ZIEL: Diese Studie evaluierte MRSA, welcher von Haustieren kultiviert wurde, sowie die Räumlichkeiten in Haushalten, in denen eine humane MRSA-Infektion bestätigt worden war und zielte darauf ab, die möglichen Risikofaktoren für ein Auftreten von MRSA bei Haustieren festzustellen.Es wurden Menschen aus den Mittelatlantikstaaten der USA ausgesucht, die mit einem MRSA aus der Bevölkerung (CA-MRSA) oder einer Weichteilinfektion (SSTI) diagnostiziert worden waren. Einhundertzweiundvierzig Hunde und Katzen von 57 verschiedenen betroffenen Haushalten wurden identifiziert, wobei von 134 (94,4%) Haustieren sowie dem Wohnraum Proben für bakterielle Kulturen, PCR-Bestimmung und für eine Bestimmung der spa-Typisierung der MRSA-Stämme genommen wurden. Drei Monate später wurden von 86 Haustieren Proben genommen.Am Anfang wurde bei 12 Haustieren (9,0%) MRSA festgestellt. Mögliche Risikofaktoren dafür waren eine MRSA-Kontaminierung durch das Bett des Tieres (Umwelt), Flohbefall und vorherige antimikrobielle Behandlung beim Haustier. Die Haustiere tendierten zum Tragen von an den Menschen angepassten MRSA-Stämmen und die spa-Typen von MRSA-Isolaten, die von Tieren kultiviert worden waren, stimmten mit den Stämmen überein, die aus dem Wohnraum von sieben der acht Haushalte (87,5%) zum Ausgangszeitpunkt kultiviert worden waren.Diese Ergebnisse könnten für Risiko-basierte veterinärmedizinische klinische Empfehlungen Informationen liefern sowie Evidenz zur selektiven Untersuchung von Haustieren als mögliche Alternative zu einer frühzeitigen Entnahme der Haustiere aus Haushalten mit Menschen, die mit MRSA infiziert waren. Die MRSA-Kontaminierung des Wohnraums ist ein möglicher Risikofaktor dafür, dass Haustiere MRSA tragen und Interventionen im Haushalt sollten bedacht werden, um das Risiko von MRSA Trägern bei exponierten Haustieren zu reduzieren.背景:家庭宠物可以携带由其主人引入家庭的耐甲氧西林金黄色葡萄球菌 (MRSA)。促进宠物携带该病原体的具体因素尚未完全阐明。 目的:本研究评价了在已确定 MRSA 人类感染的家庭中，从宠物和家庭环境中培养的MRSA，旨在确定携带宠物 MRSA 的潜在风险因素。 材料和方法:确定在大西洋中部美国诊断为社交相关 MRSA(CA-MRSA) 皮肤或软组织感染 (SSTI) 的人类。鉴定57个发病家庭的142只犬猫，其中134只 (94.4%) 宠物和家庭环境采样进行细菌培养、PCR确认和 spa型 进行 MRSA 菌株测定。三个月后从86只宠物中采集样本。 结果:基础状态下，12只 (9.0%) 宠物携带MRSA。与携带相关的潜在风险因素包括宠物床(环境)MRSA污染、跳蚤感染和宠物先前使用抗菌药物。宠物往往携带人类适应的 MRSA 菌株，从宠物身上培养的 spa型 MRSA 分离株与八个家庭中七个家庭(87.5%)的家庭环境中培养的菌株基本一致。 结论和临床相关性:研究结果可能为基于风险的兽医临床建议提供信息，并为选择性宠物检测提供证据，作为早期将宠物从感染MRSA的人类家中移走的可能替代方法。家庭环境中的耐甲氧西林金黄色葡萄球菌污染可能是宠物携带耐甲氧西林金黄色酵母菌的一个重要风险因素，应考虑家庭干预措施，以降低暴露宠物携带耐假氧西林金黄色葡萄球菌的风险。.背景:家庭宠物可以携带由其主人引入家庭的耐甲氧西林金黄色葡萄球菌 (MRSA)。促进宠物携带该病原体的具体因素尚未完全阐明。 目的:本研究评价了在已确定 MRSA 人类感染的家庭中，从宠物和家庭环境中培养的MRSA，旨在确定携带宠物 MRSA 的潜在风险因素。 材料和方法:确定在大西洋中部美国诊断为社交相关 MRSA(CA-MRSA) 皮肤或软组织感染 (SSTI) 的人类。鉴定57个发病家庭的142只犬猫，其中134只 (94.4%) 宠物和家庭环境采样进行细菌培养、PCR确认和 spa型 进行 MRSA 菌株测定。三个月后从86只宠物中采集样本。 结果:基础状态下，12只 (9.0%) 宠物携带MRSA。与携带相关的潜在风险因素包括宠物床(环境)MRSA污染、跳蚤感染和宠物先前使用抗菌药物。宠物往往携带人类适应的 MRSA 菌株，从宠物身上培养的 spa型 MRSA 分离株与八个家庭中七个家庭(87.5%)的家庭环境中培养的菌株基本一致。 结论和临床相关性:研究结果可能为基于风险的兽医临床建议提供信息，并为选择性宠物检测提供证据，作为早期将宠物从感染MRSA的人类家中移走的可能替代方法。家庭环境中的耐甲氧西林金黄色葡萄球菌污染可能是宠物携带耐甲氧西林金黄色酵母菌的一个重要风险因素，应考虑家庭干预措施，以降低暴露宠物携带耐假氧西林金黄色葡萄球菌的风险。.Animais domésticos podem ser portadores de Staphylococcus aureus resistente à meticilina (MRSA) introduzidos em casa pelos seus contactantes humanos. Fatores específicos que promovem o carreamento deste patógeno pelos pets ainda não foram elucidados completamente.Este estudo avaliou MRSA cultivados de pets e seus domicílios em casas onde infecção humana por MRSA foi identificada, e teve como objetivo determinar os potenciais fatores de risco para carreamento de MRSA por pets. MATERIAIS E MÉTODOS: Humanos diagnosticados com infecção cutânea ou de tecidos moles (SSTI) por MRSA comunitário (MRSA-C) na região do meio-atlântico dos Estados Unidos foram identificados. Cento e quarenta e dois cães e gatos de 57 domicílios identificados, dos quais 134 (94,4%) pets e o ambiente doméstico foram amostrados por cultura bacteriana, confirmação por PCR e tipificação de spa para determinação da cepa de MRSA. Três meses depois, amostras foram coletadas de 86 animais.No tempo 0, 12 (9,0%) pets eram portadores de MRSA. Os fatores de risco potenciais para o carreamento de MRSA incluíram contaminação das camas dos animais por MRSA, infestação por pulgas e uso prévio de antibióticos nos pets. Os pets apresentaram uma tendência de carrear cepas de MRSA adaptadas a humanos e os tipos de spa de isolados de MRSA cultivados de pets foram análogos às cepas cultivadas de seus domicílios em sete de oito casas (87,5%) no tempo 0. CONCLUSÕES E RELEVÂNCIA CLÍNICA: Os resultados podem fundamentar recomendações clínicas veterinárias baseadas nos riscos e fornecer evidências para testagem de pets selecionados como uma alternativa à remoção precoce de pets dos domicílios de humanos infectados por MRSA. A contaminação da casa por MRSA provavelmente é um fator de risco importante para o carreamento de MRSA por pets, e intervenções no ambiente doméstico devem ser consideradas para reduzir o risco de carreamento de MRSA em pets expostos.

Industrial hog operation (IHO) workers can be occupationally exposed to Staphylococcus aureus and may carry the bacteria in their nares. Workers may persistently carry S. aureus or transition between different states of nasal carriage over time: no nasal carriage, nasal carriage of a human-associated strain, and nasal carriage of a livestock-associated strain. We aimed to develop a mathematical model to predict the proportion of IHO workers in each nasal carriage state over time, accounting for IHO worker mask use. We also examined data sufficiency requirements to inform development of models that produce reliable predictions. We used nasal carriage data from a cohort of 101 IHO workers in North Carolina, sampled every two weeks for 4 months, to develop a three state Markov model that describes the transition dynamics of IHO worker nasal carriage status over the study period and at steady state. We also stratified models by mask use to examine its impact on worker transition dynamics. If conditions remain the same, our models predicted that 49.1% of workers will have no nasal carriage of S. aureus, 28.2% will carry livestock-associated S. aureus, and 22.7% will carry human-associated S. aureus at steady state. In stratified models, at steady state, workers who reported only occasional mask (

Extreme precipitation events (EPE) change the natural and built environments and alter human behavior in ways that facilitate infectious disease transmission. EPEs are expected with high confidence to increase in frequency and are thus of great public health importance. This scoping review seeks to summarize the mechanisms and severity of impacts of EPEs on infectious diseases, to provide a conceptual framework for the influence of EPEs on infectious respiratory diseases, and to define areas of future study currently lacking in this field. The effects of EPEs are well-studied with respect to enteric, vector-borne, and allergic illness where they are shown to moderately increase risk of illness, but not well-understood in relation to infectious respiratory illness. We propose a framework for a similar influence of EPEs on infectious respiratory viruses through several plausible pathways: decreased UV radiation, increased ambient relative humidity, and changes to human behavior (increased time indoors and use of heating and cooling systems). However, limited work has evaluated meteorologic risk factors for infectious respiratory diseases. Future research is needed to evaluate the effects of EPEs on infectious respiratory diseases using individual-level case surveillance, fine spatial scales, and lag periods suited to the incubation periods of the disease under study, as well as a full characterization of susceptible, vulnerable, and sensitive population characteristics.

SummarySARS-CoV-2 (CoV-2), which surfaced in late 2019 in Wuhan City, China, most likely originated in bats and rapidly spread among humans globally, harming and disrupting livelihoods worldwide. Early into the pandemic, reports of CoV-2 diagnoses in pets and other animals emerged, including dogs, cats, farmed mink and some large felids (tigers and lions) from various countries. While most CoV-2 positive animals were confirmed to have been in close contact with CoV-2 positive humans, there has been a paucity of published evidence to-date describing risk factors associated with CoV-2 transmission among humans and domestic and wild animals. The COVID-19 Human-Animal Interactions Survey (CHAIS) was developed through a cross-CEIRS Center collaboration to provide a standardized survey describing human-animal interaction during the pandemic and to evaluate behavioral, spatiotemporal, and biological risk factors associated with bi-directional zoonotic transmission of CoV-2 within households and other shared environments. CHAIS measures four broad domains of transmission risk; 1) intensity and risk of infection among human hosts, 2) spatial characteristics of shared environments, 3) behaviors and human-animal interactions, and 4) animal susceptibility to infection and propensity for onward spread. Following the development of CHAIS, with a One Health approach, a multidisciplinary group of experts (n=20) was invited to review and provide feedback on the survey for content validity. Expert feedback was incorporated into two final survey formats-a long-form and an abridged version for which specific core questions addressing zoonotic and reverse zoonotic transmission were identified. Both forms are modularized, with each section having the capacity to serve as independent instruments, allowing researchers to customize the survey based on context and research-specific needs. Further adaptations for studies seeking to investigate other zoonotic pathogens with similar routes of transmission (i.e. respiratory, direct contact) are also possible. The CHAIS instrument is a standardized human-animal interaction survey developed to provide important data on risk factors that guide transmission of CoV-2 from humans to animals, with great utility in capturing information of zoonotic transmission risk factors for CoV-2 and other similar pathogens.ImpactsWe present a standardized survey instrument for evaluating risk factors associated with bi-directional zoonotic transmission of SARS-CoV-2 and other similarly transmitted pathogens in household and other settings where humans and animals share close contact.The CHAIS instrument evaluates behavioral, spatiotemporal, and host determinants of transmission risk of SARS-CoV-2 and is highly adaptable for use in studies seeking to investigate other zoonotic pathogens such as influenza viruses.This standardized instrument will enable pooling of data across studies for meta-analyses to improve predictive models of bi-directional transmission of SARS-CoV-2 among humans and animals and will inform public health prevention and mitigation measures.

Humans, animals, and the environment face a universal crisis: antimicrobial resistance (AR). Addressing AR and its multi-disciplinary causes across many sectors including in human and veterinary medicine remains underdeveloped. One barrier to AR efforts is an inconsistent process to incorporate the plenitude of stakeholders about what AR is and how to stifle its development and spread—especially stakeholders from the animal agriculture sector, one of the largest purchasers of antimicrobial drugs. In 2019, The Wellcome Trust released Reframing Resistance: How to communicate about antimicrobial resistance effectively (Reframing Resistance), which proposed the need to establish a consistent and harmonized messaging effort that describes the AR crisis and its global implications for health and wellbeing across all stakeholders. Yet, Reframing Resistance does not specifically engage the animal agriculture community. This study investigates the gap between two principles recommended by Reframing Resistance and animal agriculture stakeholders. For this analysis, the research group conducted 31 semi-structured interviews with a diverse group of United States animal agriculture stakeholders. Participants reported attitudes, beliefs, and practices about a variety of issues, including how they defined AR and what entities the AR crisis impacts most. Exploration of Reframing Resistance’s Principle 2, “explain the fundamentals succinctly” and Principle 3, “emphasis that this is universal issue; it can affect anyone, including you” reveals disagreement in both the fundamentals of AR and consensus of “who” the AR crisis impacts. Principle 2 may do better to acknowledge that animal agriculture stakeholders espouse a complex array of perspectives that cannot be summed up in a single perspective or principle. As a primary tool to combat AR, behavior change must be accomplished first through outreach to stakeholder groups and understanding their perspectives.

Children spend the majority of their time indoors, and a substantial portion of this time in the school environment. Air pollution has been shown to adversely impact lung development and has effects that extend beyond respiratory health. The goal of this study was to evaluate the indoor environment in public schools in the context of an ongoing urban renovation program to investigate the impact of school building renovation and replacement on indoor air quality. Indoor air quality (CO2, PM2.5, CO, and temperature) was assessed for two weeks during fall, winter, and spring seasons in 29 urban public schools between December 2015 and March 2020. Seven schools had pre- and post-renovation data available. Linear mixed models were used to examine changes in air quality outcomes by renovation status in the seven schools with pre- and post-renovation data. Prior to renovation, indoor CO measurements were within World Health Organization (WHO) guidelines, and indoor PM2.5 measurements rarely exceeded them. Within the seven schools with pre- and post-renovation data, over 30% of indoor CO2 measurements and over 50% of indoor temperatures exceeded recommended guidelines from the American Society of Heating, Refrigerating, and Air Conditioning Engineers. Following renovation, 10% of indoor CO2 measurements and 28% of indoor temperatures fell outside of the recommended ranges. Linear mixed models showed significant improvement in CO2, indoor PM2.5, and CO following school renovation. Even among schools that generally met recommendations on key guidelines, school renovation improved the indoor air quality. Our findings suggest that school renovation may benefit communities of children, particularly those in low-income areas with aging school infrastructure, through improvements in the indoor environment.

Salon workers, especially those serving an ethnically and racially diverse clientele (i.e., Black/Latina), may experience disparately high levels of workplace exposures to respiratory irritants, including volatile organic compounds (VOCs). Salon workers are also reported to have a greater risk of developing respiratory conditions compared to the general population. Emerging evidence suggests that occupational chemical exposures may alter the human microbiome and that these alterations may be an important mechanism by which workplace VOC exposures adversely impact respiratory health. This preliminary research investigated the potential effects of 28 VOC urinary biomarkers on the 16S rRNA nasal microbiome in 40 workers from salons primarily serving women of color (Black and Dominican salons) compared to office workers. Our exploratory analysis revealed significant differences in microbial composition by worker group; namely dissimilar levels of Staphylococcus species (S. epidermidis and S. aureus, specifically) in salon workers compared to office workers, and higher alpha diversity levels in workers in Dominican salons compared to workers in Black salons. Within-sample alpha diversity levels tended to be decreased with higher VOC urinary biomarker concentrations, significantly for carbon disulfide, acrolein, acrylonitrile, crotonaldehyde, and vinyl chloride biomarkers. Our research highlights that occupational exposures, particularly to chemicals like VOCs, can impact the respiratory microbiome in the vulnerable salon worker group. Further understanding of the potential effects of chemical mixtures on microbial composition may provide key insights to respiratory health and other adverse health outcomes, as well as direct prevention efforts in this largely historically understudied occupational population.

Background: During food animal production, animals are exposed to, colonized by, and sometimes infected with bacteria that may contaminate animal products with susceptible and multidrug-resistant organisms (MDRO). The United States’ Organic Foods Production Act resulted in decreased antibiotic use in some animal production operations. Some studies have reported that decreased antibiotic use is associated with reduced MDRO on meat. Objectives: The aim of this study was to investigate associations of meat production and processing methods with MDRO and overall bacterial contamination of retail meats. Methods: Bacterial contamination data from 2012 to 2017 for chicken breast, ground beef, ground turkey, and pork chops were downloaded from the National Antimicrobial Resistance Monitoring System. Poisson regression models with robust variance were used to estimate associations with MDRO contamination and any contamination (adjusted for year and meat type) overall, and according to bacteria genus (Salmonella, Campylobacter, Enterococcus, Escherichia coli) and meat type. Results: A total of 39,349 retail meat samples were linked to 216 conventional, 123 split (conventional and organic), and three organic processing facilities. MDRO contamination was similar in conventionally produced meats processed at split vs. conventional facilities but was significantly lower in organically produced meats processed at split facilities [adjusted prevalance ratio (aPR)=0.43; 95% CI: 0.30, 0.63]. Meat processed by split vs. conventional processors had higher or similar MDRO contamination for all tested bacterial genera except Campylobacter (aPR=0.29; 95% CI: 0.13, 0.64). The prevalence of any contamination was lower in samples processed at split vs. conventional facilities for aggregated samples (aPR=0.70; 95% CI: 0.68, 0.73) and all meat types and bacterial genera. Discussion: Organically produced and processed retail meat samples had a significantly lower prevalence of MDRO than conventionally produced and processed samples had, whereas meat from split processors had a lower prevalence of any contamination than samples from conventional processors had. Additional studies are needed to confirm findings and clarify specific production and processing practices that might explain them. https://doi.org/10.1289/EHP7327

Veterinary and animal care workers perform critical functions in biosecurity and public health, yet little has been done to understand the unique needs and barriers these workers face when responding during a pandemic crisis. In this article, we evaluated the perceived risks and roles of veterinary and animal care workers during the COVID-19 pandemic and explored barriers and facilitators in their readiness, ability, and willingness to respond during a pandemic. We deployed a survey targeting US veterinary medical personnel, animal shelter and control workers, zoo and wildlife workers, and other animal care workers. Data were collected on respondents' self-reported job and demographic factors, perceptions of risk and job efficacy, and readiness, ability, and willingness to respond during the pandemic. We found that leadership roles and older age had the strongest association with decreased perceived risk and improved job efficacy and confidence, and that increased reported contact level with others (both coworkers and the public) was associated with increased perceived risk. We determined that older age and serving in leadership positions were associated with improved readiness, willingness, and ability to respond. Veterinary and animal care workers' dedication to public health response, reflected in our findings, will be imperative if more zoonotic vectors of SARS-CoV-2 arise. Response preparedness in veterinary and animal care workers can be improved by targeting younger workers not in leadership roles through support programs that focus on improving job efficacy and confidence in safety protocols. These findings can be used to target intervention and training efforts to support the most vulnerable within this critical, yet often overlooked, workforce.

The success of a One Health approach to combating antimicrobial resistance (AMR) requires effective data sharing across the three One Health domains (human, animal, and environment). To investigate if there are differences in language use across the One Health domains, we examined the peer-reviewed literature using a combination of text data mining and natural language processing techniques on 20,000 open-access articles related to AMR and One Health. Evaluating AMR key term frequency from the European PubMed Collection published between 1990 and 2019 showed distinct AMR language usage within each domain and incongruent language usage across domains, with significant differences in key term usage frequencies when articles were grouped by the One Health sub-specialties (2-way ANOVA, p &lt, 0.001). Over the 29-year period, “antibiotic resistance” and “AR” were used 18 times more than “antimicrobial resistance” and “AMR”. The discord of language use across One Health potentially weakens the effectiveness of interdisciplinary research by creating accessibility issues for researchers using search engines. This research was the first to quantify this disparate language use within One Health, which inhibits collaboration and crosstalk between domains. We suggest the following for authors publishing AMR-related research within the One Health context: (1) increase title/abstract searchability by including both antimicrobial and antibiotic resistance related search terms, (2) include “One Health” in the title/abstract, and (3) prioritize open-access publication.

Therapy animals in hospital animal-assisted intervention programs are an invaluable part of holistic patient care. However, therapy dogs may be exposed to hospital-associated pathogens through these activities. This pilot study sought to examine the effect of topical chlorhexidine application, used as an infection control measure, on the microbial composition of the skin and mucous membranes of therapy dogs. We found that the chlorhexidine decolonization intervention altered microbial alpha diversity and shifted microbial structures in these therapy dogs, and particularly influenced more phylogenetically rare taxa. Specifically, the intervention reduced the abundance of Staphylococcus pseudintermedius, the archetypal canine commensal and a frequent cause of opportunistic infections. However, it did not reduce levels of S. aureus, which is a common hospital-associated pathogen of people. These preliminary findings highlight the importance of considering holistic microbial communities when undertaking infection control strategies, and stress the need for further research to understand the unintended consequences of antiseptic use on therapy dogs.

BackgroundMicrobial sharing between humans and animals has been demonstrated in a variety of settings. However, the extent of microbial sharing that occurs within the healthcare setting during animal-assisted intervention programs, a validated and valuable part of holistic patient wellness, is unknown. Understanding microbial transmission between patients and therapy animals can provide important insights into potential health benefits for patients, in addition to addressing concerns regarding potential pathogen transmission that limits program utilization. This study evaluated the potential for microbial sharing between pediatric patients and therapy dogs, and tested whether patient-dog contact level and a dog decolonization protocol modified this sharing.Methods and ResultsPatients, therapy animals, and the hospital environment were sampled before and after every group therapy session and samples underwent 16S rRNA sequencing to characterize microbial communities. Both patients and animals experienced changes in the relative abundance and overall diversity of their nasal microbiome, suggesting that exchange of microorganisms had occurred. Increased contact was associated with greater sharing between patients and therapy animals, as well as between patients. A topical chlorhexidine-based dog decolonization intervention was associated with decreased microbial sharing between therapy dogs and patients, particularly from the removal of rarer microbiota from the dog, but did not significantly affect sharing between patients.ConclusionThese data suggest that the therapy animal is both a potential source of and a vehicle for the transfer of microorganisms to patients but not necessarily the only source. The relative contribution of other potential sources (e.g., other patients, the hospital environment) should be further explored to determine their relative importance.

Using previously validated microbial source tracking markers, we detected and quantified fecal contamination from avian species and avian exposure, dogs, and humans on household cooking tables and floors. The association among contamination, infrastructure, and socioeconomic covariates was assessed using simple and multiple ordinal logistic regressions. The presence ofCampylobacterspp. in surface samples was linked to avian markers. Using molecular methods, animal feces were detected in 75.0% and human feces in 20.2% of 104 households. Floors were more contaminated than tables as detected by the avian markerAv4143, dog markerBactcan, and human markerBachum. Wood tables were consistently more contaminated than non-wood surfaces, specifically with the mitochondrial avian markersND5and CytB, fecal marker Av4143, and canine markerBactcan. Final multivariable models with socioeconomic and infrastructure characteristics included as covariates indicate that detection of avian feces and avian exposure was associated with the presence of chickens, maternal age, and length of tenancy, whereas detection of human markers was associated with unimproved water source. Detection ofCampylobacterin surface samples was associated with the avian fecal marker Av4143. We highlight the critical need to detect and measure the burden of animal fecal waste when evaluating household water, hygiene, and sanitation interventions, and the possibility of decreasing risk of exposure through the modification of surfaces to permit more effective household disinfection practices. Animals may be a more important source of household fecal contamination than humans in many low-resource settings, although interventions have historically focused almost exclusively on managing human waste.