ABSTRACT
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.
Subject(s)
Disease Outbreaks/veterinary , Influenza A Virus, H7N2 Subtype/isolation & purification , Influenza, Human/transmission , Orthomyxoviridae Infections/veterinary , Animals , Antibodies, Viral/blood , Cats , Humans , Influenza A Virus, H7N2 Subtype/genetics , Influenza A virus/immunology , Influenza, Human/epidemiology , Influenza, Human/virology , New York City/epidemiology , Orthomyxoviridae Infections/epidemiology , Orthomyxoviridae Infections/virology , Polymerase Chain ReactionABSTRACT
In response to two isolated cases of Mycobacterium chelonae infections in tattoo recipients where tap water was used to dilute ink, the New York City (NYC) Department of Health and Mental Hygiene conducted an investigation using Emergency Department (ED) syndromic surveillance to assess whether an outbreak was occuring. ED visits with chief complaints containing the key word "tattoo" from November 1, 2012 to March 18, 2013 were selected for study. NYC laboratories were also contacted and asked to report skin or soft tissue cultures in tattoo recipients that were positive for non-tuberculosis mycobacterial infection (NTM). Thirty-one TREDV were identified and 14 (45%) were interviewed to determine if a NTM was the cause for the visit. One ED visit met the case definition and was referred to a dermatologist. This individual was negative for NTM. No tattoo-associated NTM cases were reported by NYC laboratories. ED syndromic surveillance was utilized to investigate a non-reportable condition for which no other data source existed. The results were reassuring that an outbreak of NTM in tattoo recipients was not occurring. In response to concerns about potential NTM infections, the department sent a letter to all licensed tattoo artists advising them not to dilute tattoo ink with tap water.
Subject(s)
Epidemiological Monitoring , Fresh Water/microbiology , Mycobacterium Infections, Nontuberculous/epidemiology , Skin Diseases, Infectious/epidemiology , Tattooing/adverse effects , Adolescent , Adult , Disease Outbreaks , Emergency Service, Hospital , Female , Humans , Ink , Male , Middle Aged , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium chelonae/isolation & purification , New York City/epidemiology , Population Surveillance , Skin/microbiology , Skin/pathology , Skin Diseases, Infectious/microbiology , Surveys and Questionnaires , Young AdultABSTRACT
OBJECTIVES: We evaluated the impact of the New York City restaurant letter-grading program on restaurant hygiene, food safety practices, and public awareness. METHODS: We analyzed data from 43,448 restaurants inspected between 2007 and 2013 to measure changes in inspection score and violation citations since program launch in July 2010. We used binomial regression to assess probability of scoring 0 to 13 points (A-range score). Two population-based random-digit-dial telephone surveys assessed public perceptions of the program. RESULTS: After we controlled for repeated restaurant observations, season of inspection, and chain restaurant status, the probability of scoring 0 to 13 points on an unannounced inspection increased 35% (95% confidence interval [CI]=31%, 40%) 3 years after compared with 3 years before grading. There were notable improvements in compliance with some specific requirements, including having a certified kitchen manager on site and being pest-free. More than 91% (95% CI=88%, 94%) of New Yorkers approved of the program and 88% (95% CI=85%, 92%) considered grades in dining decisions in 2012. CONCLUSIONS: Restaurant letter grading in New York City has resulted in improved sanitary conditions on unannounced inspection, suggesting that the program is an effective regulatory tool.
