ABSTRACT
On April 27, 2015, the Whatcom County Health Department (WCHD) in Bellingham, Washington, was notified by a local laboratory regarding three children with presumptive Escherichia coli O157 infection. WCHD interviewed the parents, who indicated that all three children had attended a dairy education event held in a barn April 2024, 2015, during a school field trip. WCHD, the Washington State Department of Health, and CDC investigated to determine the magnitude of the outbreak, identify risk factors and potential environmental sources of infection, and develop recommendations. A total of 60 cases (25 confirmed and 35 probable) were identified, and 11 patients were hospitalized.
Subject(s)
Dairying/education , Disease Outbreaks , Escherichia coli Infections/epidemiology , Escherichia coli O157/isolation & purification , Animals , Cattle , Child , Environmental Microbiology , Humans , Students/statistics & numerical data , Washington/epidemiologySubject(s)
Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Drug Resistance, Multiple, Bacterial , Dysentery, Bacillary/drug therapy , Shigella sonnei/drug effects , Child , Drug Resistance, Multiple, Bacterial/genetics , Female , Humans , Male , Microbial Sensitivity Tests , Shigella sonnei/genetics , United StatesABSTRACT
Bacteria of the genus Shigella cause approximately 500,000 illnesses each year in the United States. Diarrhea (sometimes bloody), fever, and stomach cramps typically start 1-2 days after exposure and usually resolve in 5-7 days. For patients with severe disease, bloody diarrhea, or compromised immune systems, antibiotic treatment is recommended, but resistance to traditional first-line antibiotics (e.g., ampicillin and trimethoprim-sulfamethoxazole) is common. For multidrugresistant cases, azithromycin, the most frequently prescribed antibiotic in the United States, is recommended for both children and adults. However, not all Shigellae are susceptible to azithromycin. Nonsusceptible isolates exist but are not usually identified because there are no clinical laboratory guidelines for azithromycin susceptibility testing. However, to monitor susceptibility of Shigellae in the United States, CDC's National Antimicrobial Resistance Monitoring System (NARMS) has, since 2011, routinely measured the azithromycin minimum inhibitory concentration (MIC) for every 20th Shigella isolate submitted from public health laboratories to CDC, as well as outbreak-associated isolates. All known U.S. Shigella isolates with decreased susceptibility to azithromycin (DSA-Shigella), and the illnesses caused by them, are described in this report.
Subject(s)
Anti-Bacterial Agents/pharmacology , Azithromycin/pharmacology , Drug Resistance, Bacterial , Dysentery, Bacillary/drug therapy , Homosexuality, Male , Shigella/drug effects , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Shigella/isolation & purification , United States , Young AdultABSTRACT
Cholera is rare in the United States (annual average 6 cases). Since epidemic cholera began in Hispaniola in 2010, a total of 23 cholera cases caused by toxigenic Vibrio cholerae O1 have been confirmed in the United States. Twenty-two case-patients reported travel to Hispaniola and 1 reported consumption of seafood from Haiti.
Subject(s)
Cholera/epidemiology , Epidemics , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Child , Cholera/therapy , Cholera/transmission , Dominican Republic/epidemiology , Female , Fluid Therapy , Haiti/epidemiology , Humans , Male , Middle Aged , Travel , United States/epidemiology , Vibrio cholerae O1/isolation & purification , Young AdultABSTRACT
To enhance the timeliness of medical evaluation for cholera-like illness during the 2011 cholera outbreak in Hispaniola, printed Travel Health Alert Notices (T-HANs) were distributed to travelers from Haiti to the United States. Evaluation of the T-HANs' influence on travelers' health careseeking behavior suggested T-HANs might positively influence health careseeking behavior.
