Outbreak of Influenza A(H7N2) Among Cats in an Animal Shelter With Cat-to-Human Transmission-New York City, 2016.

We describe the first case of cat-to-human transmission of influenza A(H7N2), an avian-lineage influenza A virus, that occurred during an outbreak among cats in New York City animal shelters. We describe the public health response and investigation.

Characteristics of the Built Environment and the Presence of the Norway Rat in New York City: Results From a Neighborhood Rat Surveillance Program, 2008-2010.

Characteristics of an urban setting such as New York City (NYC), including readily available putrescible waste and ample underground infrastructure, make it highly attractive to the Norway rat (Rattus norvegicus). To identify property and neighborhood characteristics associated with rat presence, recent inspectional results were analyzed from over 77,000 properties in the Bronx and Manhattan. Variables capturing the location and density of factors believed to promote rat populations were tested individually and in combination in models predicting rat activity. We found that property-specific characteristics typically associated with high garbage volume, including large numbers of residential units, public ownership, and open-space designation (parks, outdoor recreation, or vacant land) were the most important factors in explaining increased rat presence across neighborhoods in NYC. Interventions that involved improved garbage management and street sanitation within a designated area reduced the likelihood of finding rats, especially in medium- and high-poverty neighborhoods. Neighborhood characteristics, such as being near a railroad or subway line, having a school nearby, the presence of numerous restaurants, or having older infrastructure, also contributed to the increased likelihood of rats. Our results support the use of built environment data to target community-level interventions and capture emerging rat infestations.

Zika Virus Surveillance and Preparedness - New York City, 2015-2016.

Zika virus has rapidly spread through the World Health Organization's Region of the Americas since being identified in Brazil in early 2015. Transmitted primarily through the bite of infected Aedes species mosquitoes, Zika virus infection during pregnancy can cause spontaneous abortion and birth defects, including microcephaly (1,2). New York City (NYC) is home to a large number of persons who travel frequently to areas with active Zika virus transmission, including immigrants from these areas. In November 2015, the NYC Department of Health and Mental Hygiene (DOHMH) began developing and implementing plans for managing Zika virus and on February 1, 2016, activated its Incident Command System. During January 1-June 17, 2016, DOHMH coordinated diagnostic laboratory testing for 3,605 persons with travel-associated exposure, 182 (5.0%) of whom had confirmed Zika virus infection. Twenty (11.0%) confirmed patients were pregnant at the time of diagnosis. In addition, two cases of Zika virus-associated Guillain-Barré syndrome were diagnosed. DOHMH's response has focused on 1) identifying and diagnosing suspected cases; 2) educating the public and medical providers about Zika virus risks, transmission, and prevention strategies, particularly in areas with large populations of immigrants from areas with ongoing Zika virus transmission; 3) monitoring pregnant women with Zika virus infection and their fetuses and infants; 4) detecting local mosquito-borne transmission through both human and mosquito surveillance; and 5) modifying existing Culex mosquito control measures by targeting Aedes species of mosquitoes through the use of larvicides and adulticides.

A simplified screening procedure for determination of total N-NO groups (TNG) and nitrite (NO2-) in commercial low-molecular-weight heparins (LMWH) by selective chemical denitrosation followed by high-sensitivity chemiluminescence detection (NO-analyzer, NOA).

Aim of this work was to set up a method for the sensitive and selective determination of nitrite (NO(2)(-)) and total N-nitroso groups (TNG) in dalteparin and nadroparin, commercial low- molecular-weight heparins (LMWH), prepared by deaminative depolymerization of heparin with nitrous acid. The European Pharmacopoeia VI ed. indicates respectively 5 ppm as the maximum content for contaminant NO(2)(-) in the former and 0.25 ppm for TNG in the latter and no clear indication is given for N-NO groups in dalteparin, i.e. TNG must be absent because of the specific manufacturing process. The proposed technique is based on the development of a pre-analytical device, coupled to a chemiluminometer, constituted by three sequentially connected and commercially available purge vessels, where selective reagents are employed for the conversion of NO(2)(-) and N-NO to nitric oxide (NO). In detail, NO(2)(-) was determined in the first chamber and non-volatile and volatile TNG in the second and third. This method was validated for selectivity, sensitivity, linearity, accuracy and precision. The method was shown to be selective, with a quantitative linear range of 1-1000 ppb). The bias, intra- and inter-day percent relative error was lower than 1%. The contamination of NO(2)(-) and TNG in nadreparin was below the limits; for dalteparin NO(2)(-) fell within the limit, but there was a huge amount of TNG (15.80+/-0.05 ppm-6.69+/-0.02 ppm). Preliminary investigation on the solvent-extractable material from dalteparin showed the majority of chemiluminescence retained in the aqueous residue to indicate that this N-NO groups may belong to solvent unextractable material or be tightly bound to the dalteparin backbone.

Shortchanged? An assessment of chronic disease programming in major US city health departments.

A self-administered survey was distributed to members of The Big Cities Health Coalition, a group of Health Officers/Commissioners from 17 of the largest US metropolitan health departments. The survey asked participants about their chronic disease priorities, data sources, budgets, and funding sources as well as examples of successful chronic disease interventions. Members of the Coalition discussed the survey results in a scheduled conference call. Chronic diseases account for 70% of all deaths nationwide on average, yet the health departments surveyed allocated an average of 1.85% of their budgets to chronic disease. Average chronic disease spending per inhabitant was 2.33 dollars, with a median of 1.56 dollars. Among the group's top chronic disease priorities were asthma, diabetes, tobacco, cancer, and cardiovascular disease (CVD). Nearly half of the group's chronic disease spending was on tobacco. Chronic disease funding sources varied across localities, but direct federal funding was minimal. In 14 cities serving a combined 37 million people (13% of the US population), direct federal chronic disease funding totaled 8.7 million dollars, an average of 0.24 dollars per capita. The group described successful chronic disease interventions, particularly related to tobacco and asthma.

Identifying West Nile virus risk areas: the Dynamic Continuous-Area Space-Time system.

The Dynamic Continuous-Area Space-Time (DYCAST) system was developed to identify and prospectively monitor high-risk areas for West Nile virus in New York, New York (New York City). The system is based on a geographic model that uses a localized Knox test to capture the nonrandom space-time interaction of dead birds, as an indicator of an intense West Nile virus amplification cycle, within a 1.5-mile (2.41-km) buffer area and 21-day moving window. The Knox analysis is implemented as an interpolation function to create a surface of probabilities over a grid of 1,400 cells overlaying New York City. The model's parameters were calibrated using year 2000 data and information on the vector-host transmission cycle. The DYCAST system was implemented in a geographic information system and used operationally in year 2001. It successfully identified areas of high risk for human West Nile virus infection in areas where five of seven human cases resided, at least 13 days prior to the onset of illness, and proved that it can be used as an effective tool for targeting remediation and control efforts.

Spatial analysis of West Nile virus: rapid risk assessment of an introduced vector-borne zoonosis.

The distribution of human risk for West Nile virus was determined by spatial analysis of the initial case distribution for the New York City area in 1999 using remote sensing and geographic information system technologies. Cluster analysis revealed the presence of a statistically significant grouping of cases, which also indicates the area of probable virus introduction. Within the cluster, habitat suitability for potentially infective adult mosquitoes was measured by the amount of vegetation cover using satellite imagery. Logistic regression analysis revealed satellite-derived vegetation abundance to be significantly and positively associated with the presence of human cases. The logistic model was used to estimate the spatial distribution of human risk for West Nile virus throughout New York City. Accuracy of the resulting risk map was cross-validated using virus-positive mosquito sample sites. These new epidemiological methods aid in rapid entry point identification and spatial prediction of human risk of infection for introduced vector-borne pathogens.