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1.
Am J Infect Control ; 41(10): 936-8, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23870793

ABSTRACT

During the investigation of an outbreak of Escherichia coli O157:H7 in a child care center, illness logs were reviewed and parents interviewed to identify classroom and household exposures. Costs incurred by the center and the public health laboratory were estimated from self-administered questionnaires. We conclude that household transmission played a role in this outbreak and estimate the cost of investigation and intervention at over $6,000 per case.


Subject(s)
Child Day Care Centers , Disease Outbreaks , Escherichia coli Infections/epidemiology , Escherichia coli Infections/transmission , Escherichia coli O157/isolation & purification , Family Characteristics , Adult , Child, Preschool , Escherichia coli Infections/microbiology , Health Care Costs , Humans , Illinois/epidemiology , Infant , Infection Control/economics , Infection Control/methods
2.
Clin Infect Dis ; 45(4): 416-20, 2007 Aug 15.
Article in English | MEDLINE | ID: mdl-17638187

ABSTRACT

BACKGROUND: Human adenovirus type 3 (HAdV-3) causes severe respiratory illness in children, but outbreaks in long-term care facilities have not been frequently reported. We describe an outbreak of HAdV-3 infection in a long-term care facility for children with severe neurologic impairment, where only 3 of 63 residents were ambulatory. METHODS: A clinical case of HAdV-3 was defined as fever (temperature, > or = 38.0 degrees C) and either a worsening of respiratory symptoms or conjunctivitis in a resident, with illness onset from June through August 2005. We reviewed medical records; conducted surveillance for fever, conjunctivitis, and respiratory symptoms; and collected nasopharyngeal and conjunctival specimens from symptomatic residents. Specimens were cultured in HAdV-permissive cell lines or were analyzed by HAdV-specific polymerase chain reaction assay. RESULTS: Thirty-five (56%) of 63 residents had illnesses that met the case definition; 17 patients (49%) were admitted to intensive care units, and 2 (6%) died. Patients were hospitalized in the intensive care unit for a total of 233 patient-days. Illness onset dates ranged from 1 June through 24 August 2005. Thirty-two patients (91%) had respiratory infection, and 3 (9%) had conjunctivitis. HAdV was identified by culture or PCR in 20 patients. Nine isolates were characterized as HAdV-3 genome type a2. CONCLUSIONS: Considering the limited mobility of residents and their reliance on respiratory care, transmission of HAdV-3 infection during this outbreak likely occurred through respiratory care provided by staff. In environments where patients with susceptible underlying conditions reside, HAdV infection should be considered when patients are identified with worsening respiratory disease, and rapid diagnostic tests for HAdV infection should be readily available to help identify and curtail the spread of this pathogen.


Subject(s)
Adenovirus Infections, Human/epidemiology , Cross Infection/epidemiology , Disease Outbreaks , Adenovirus Infections, Human/prevention & control , Adenovirus Infections, Human/virology , Adenoviruses, Human/classification , Adenoviruses, Human/genetics , Adenoviruses, Human/isolation & purification , Adolescent , Adult , Child , Child, Preschool , Cross Infection/prevention & control , Cross Infection/virology , Disease Outbreaks/prevention & control , Health Facilities , Humans , Illinois/epidemiology , Infant , Long-Term Care
3.
Am J Trop Med Hyg ; 72(6): 768-76, 2005 Jun.
Article in English | MEDLINE | ID: mdl-15964962

ABSTRACT

In 2002, the world's largest outbreak of neuroinvasive West Nile virus (WNV) disease occurred. Illinois reported 21% of the total cases in the United States, the most among all states. The epidemiology of WNV in Illinois in 2002 was examined to determine factors associated with severe disease and death. A total of 884 cases were identified and there were 66 deaths. The overall attack rate of WNV infection was 7.1 per 100,000 population and this increased with age. The median ages of patients and patients who died were 56 and 78 years, respectively. Among patients who died, 91% were diagnosed with encephalitis and the case-fatality rate for patients with encephalitis was 18.6%. Patients more than 50 years old had a significantly higher risk of being reported with encephalitis (relative risk [RR] = 3.3, 95% confidence interval [CI] = 2.6-4.3%) and death (RR = 22.3, 95% CI = 5.5-90.4%). Clinicians evaluating elderly patients with WNV infection should assess patients closely for progression of disease.


Subject(s)
Disease Outbreaks , West Nile Fever/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Birds/virology , Child , Child, Preschool , Enzyme-Linked Immunosorbent Assay , Humans , Illinois/epidemiology , Infant , Middle Aged , Population Surveillance , West Nile virus/isolation & purification
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