Multistate outbreak of Salmonella enterica serotype enteritidis infection associated with pet guinea pigs.

Salmonella causes about one million illnesses annually in the United States. Although most infections result from foodborne exposures, animal contact is an important mode of transmission. We investigated a case of Salmonella enterica serotype Enteritidis (SE) sternal osteomyelitis in a previously healthy child who cared for two recently deceased guinea pigs (GPs). A case was defined as SE pulsed-field gel electrophoresis (PFGE) XbaI pattern JEGX01.0021, BlnI pattern JEGA26.0002 (outbreak strain) infection occurring during 2010 in a patient who reported GP exposure. To locate outbreak strain isolates, PulseNet and the US Department of Agriculture National Veterinary Service Laboratories (NVSL) databases were queried. Outbreak strain isolates underwent multilocus variable-number tandem repeat analysis (MLVA). Traceback and environmental investigations were conducted at homes, stores, and breeder or broker facilities. We detected 10 cases among residents of eight states and four NVSL GP outbreak strain isolates. One patient was hospitalized; none died. The median patient age was 9.5 (range, 1-61) years. Among 10 patients, two purchased GPs at independent stores, and three purchased GPs at different national retail chain (chain A) store locations; three were chain A employees and two reported GP exposures of unknown characterization. MLVA revealed four related patterns. Tracebacks identified four distributors and 92 sources supplying GPs to chain A, including one breeder potentially supplying GPs to all case-associated chain A stores. All environmental samples were Salmonella culture-negative. A definitive SE-contaminated environmental source was not identified. Because GPs can harbor Salmonella, consumers and pet industry personnel should be educated regarding risks.

Assessing the efficacy of video versus direct laryngoscopy through retrospective comparison of 436 emergency intubation cases.

Video laryngoscopy has become a common practice for tracheal intubations. However, information on its efficacy in emergency intubations is minimal. The external video monitor may act as a means for assistance by present staff, heighten teaching ability, and improve intubation outcomes. We conducted a retrospective review consisting of 436 patients requiring emergency intubation outside the operating room to evaluate the application of a C-MAC video laryngoscope for emergency intubation(s). Nine cases were removed, 315 underwent direct laryngoscopy, 73 underwent video laryngoscopy, and 39 underwent both methods. The C-MAC laryngoscope provided a significantly better visualization of the glottis (p = 0.02). The C-MAC also provided successful intubation on the first attempt in 82 % of the 39 direct laryngoscopy cases subsequently intubated with the C-MAC. The presence of the attending anesthesiologist (while the resident intubates) had no effect on complication rates; the number of attempts required and the grade view obtained were nonsignificant (p = 0.91 and p = 0.34, respectively). Overall, use of the C-MAC video laryngoscope provided a better view of the airway structures during an emergency intubation. The success of the C-MAC laryngoscope in intubation after failed direct laryngoscopy suggests the importance of the video laryngoscope as the primary intubation approach during an emergency intubation.

A community-based family intervention program to improve obesity in Hispanic families.

INTRODUCTION: The Waukesha County Division of Public Health and Waukesha Memorial Hospital developed a social-ecological approach to diminish the incidence of overweight and obesity in Hispanic families in Waukesha County. PROGRAM DESCRIPTION: A sample of Waukesha County children and their families participated in an 8-week program that promoted awareness of healthy food choices and the importance of physical activity. The program was selected, translated, and adapted for the Hispanic community. Weekly sessions included nutrition classes, physical activity, and a healthy meal for participating families. Biometric data were collected pre- and post-program, including blood pressure, cholesterol, glucose, weight, height, and waist measurement. A pre- and post-program knowledge test regarding nutrition, food labels, and physical activity was administered. RESULTS: A total of 47 Hispanic families participated throughout the course of the program. Biometric measures and tests of nutrition knowledge and attitudes of participants consistently showed improvements. In addition, changes occurred in the community system structure, which positively affected the built environment by improving access to parks, YMCA, and schools for family physical activity. CONCLUSION: The translated curriculum was successful in reducing cardiac and diabetes risk factors in Hispanic adults by increasing knowledge and positive attitudes about healthy behaviors.