Last data update: May 20, 2024. (Total: 46824 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Cooksey T [original query] |
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Notes from the field: Coccidioidomycosis outbreak among wildland firefighters - California, 2021
Donnelly MAP , Maffei D , Sondermeyer Cooksey GL , Ferguson TJ , Jain S , Vugia D , Materna BL , Kamali A . MMWR Morb Mortal Wkly Rep 2022 71 (34) 1095-1096 Coccidioidomycosis, also known as Valley fever, is caused by inhalation of spores of the soil-dwelling fungi Coccidioides spp. Although most illness is mild, coccidioidomycosis can cause severe disease resulting in hospitalization or death. On July 28, 2021, the California Department of Forestry and Fire Protection (CAL FIRE) notified the California Department of Public Health (CDPH) of seven wildland firefighters from two crews who had respiratory illness. Crew A (19 members) and crew B (21 members) had worked on wildfires in late June 2021 near the Tehachapi Mountains, a California region with historically high coccidioidomycosis incidence.* Among the seven symptomatic firefighters, three cases of coccidioidomycosis were laboratory-confirmed; two patients developed severe disease. All three firefighters with confirmed coccidioidomycosis reported working in dusty conditions without wearing respiratory protection. Because no vaccine for coccidioidomycosis currently exists, correct use of respiratory protection is important for preventing coccidioidomycosis, especially in regions with high disease incidence. |
Coccidioidomycosis outbreak among inmate wildland firefighters: California, 2017
Laws RL , Jain S , Cooksey GS , Mohle-Boetani J , McNary J , Wilken J , Harrison R , Leistikow B , Vugia DJ , Windham GC , Materna BL . Am J Ind Med 2021 64 (4) 266-273 BACKGROUND: In California, state prison inmates are employed to fight wildfires, which involves performing soil-disrupting work. Wildfires have become more common, including areas where Coccidioides, the soil-dwelling fungus that causes coccidioidomycosis, proliferates. However, work practices that place wildland firefighters at risk for coccidioidomycosis have not been investigated. METHODS: On August 17, 2017, the California Department of Public Health was notified of a cluster of coccidioidomycosis cases among Wildfire A inmate wildland firefighters. We collected data through medical record abstraction from suspected case-patients and mailed a survey assessing potential job task risk factors to Wildfire A inmate firefighters. We described respondent characteristics and conducted a retrospective case-control investigation to assess coccidioidomycosis risk factors. RESULTS: Among 198 inmate firefighters who worked on Wildfire A, 112 (57%) completed the survey. Of 10 case-patients (four clinical and six laboratory-confirmed), two were hospitalized. In the case-control analysis of 71 inmate firefighters, frequently cutting fire lines with a McLeod tool (odds ratio [OR]: 5.5; 95% confidence interval [CI]: 1.1-37.2) and being in a dust cloud or storm (OR: 4.3; 95% CI: 1.1-17.4) were associated with illness. Two of 112 inmate firefighters reported receiving coccidioidomycosis training; none reported wearing respiratory protection on this wildfire. CONCLUSIONS: Wildland firefighters who use hand tools and work in dusty conditions where Coccidioides proliferates are at risk for coccidioidomycosis. Agencies that employ them should provide training about coccidioidomycosis and risk reduction, limit dust exposure, and implement respiratory protection programs that specify where respirator use is feasible and appropriate. |
Rapid Sentinel Surveillance for COVID-19 - Santa Clara County, California, March 2020.
Zwald ML , Lin W , Sondermeyer Cooksey GL , Weiss C , Suarez A , Fischer M , Bonin BJ , Jain S , Langley GE , Park BJ , Moulia D , Benedict R , Nguyen N , Han GS . MMWR Morb Mortal Wkly Rep 2020 69 (14) 419-421 On February 27, 2020, the Santa Clara County Public Health Department (SCCPHD) identified its first case of coronavirus disease 2019 (COVID-19) associated with probable community transmission (i.e., infection among persons without a known exposure by travel or close contact with a patient with confirmed COVID-19). At the time the investigation began, testing guidance recommended focusing on persons with clinical findings of lower respiratory illness and travel to an affected area or an epidemiologic link to a laboratory-confirmed COVID-19 case, or on persons hospitalized for severe respiratory disease and no alternative diagnosis (1). To rapidly understand the extent of COVID-19 in the community, SCCPHD, the California Department of Public Health (CDPH), and CDC began sentinel surveillance in Santa Clara County. During March 5-14, 2020, four urgent care centers in Santa Clara County participated as sentinel sites. For this investigation, county residents evaluated for respiratory symptoms (e.g., fever, cough, or shortness of breath) who had no known risk for COVID-19 were identified at participating urgent care centers. A convenience sample of specimens that tested negative for influenza virus was tested for SARS-CoV-2 RNA. Among 226 patients who met the inclusion criteria, 23% had positive test results for influenza. Among patients who had negative test results for influenza, 79 specimens were tested for SARS-CoV-2, and 11% had evidence of infection. This sentinel surveillance system helped confirm community transmission of SARS-CoV-2 in Santa Clara County. As a result of these data and an increasing number of cases with no known source of transmission, the county initiated a series of community mitigation strategies. Detection of community transmission is critical for informing response activities, including testing criteria, quarantine guidance, investigation protocols, and community mitigation measures (2). Sentinel surveillance in outpatient settings and emergency departments, implemented together with hospital-based surveillance, mortality surveillance, and serologic surveys, can provide a robust approach to monitor the epidemiology of COVID-19. |
Surveillance for coccidioidomycosis - United States, 2011-2017
Benedict K , McCotter OZ , Brady S , Komatsu K , Sondermeyer Cooksey GL , Nguyen A , Jain S , Vugia DJ , Jackson BR . MMWR Surveill Summ 2019 68 (7) 1-15 PROBLEM/CONDITION: Coccidioidomycosis (Valley fever) is an infection caused by the environmental fungus Coccidioides spp., which typically causes respiratory illness but also can lead to disseminated disease. This fungus typically lives in soils in warm, arid regions, including the southwestern United States. REPORTING PERIOD: 2011-2017. DESCRIPTION OF SYSTEM: Coccidioidomycosis has been nationally notifiable since 1995 and is reportable in 26 states and the District of Columbia (DC), where laboratories and physicians notify local and state public health departments about possible coccidioidomycosis cases. Health department staff determine which cases qualify as confirmed cases according to the definition established by Council of State and Territorial Epidemiologists and voluntarily submit basic case information to CDC through the National Notifiable Diseases Surveillance System. RESULTS: During 2011-2017, a total of 95,371 coccidioidomycosis cases from 26 states and DC were reported to CDC. The number of cases decreased from 2011 (22,634 cases) to 2014 (8,232 cases) and subsequently increased to 14,364 cases in 2017; >95% of cases were reported from Arizona and California. Reported incidence in Arizona decreased from 261 per 100,000 persons in 2011 to 101 in 2017, whereas California incidence increased from 15.7 to 18.2, and other state incidence rates stayed relatively constant. Patient demographic characteristics were largely consistent with previous years, with an overall predominance among males and among adults aged >60 years in Arizona and adults aged 40-59 years in California. INTERPRETATION: Coccidioidomycosis remains an important national public health problem with a well-established geographic focus. The reasons for the changing trends in reported cases are unclear but might include environmental factors (e.g., temperature and precipitation), surveillance artifacts, land use changes, and changes in the population at risk for the infection. PUBLIC HEALTH ACTION: Health care providers should consider a diagnosis of coccidioidomycosis in patients who live or work in or have traveled to areas with known geographic risk for Coccidioides and be aware that those areas might be broader than previously recognized. Coccidioidomycosis surveillance provides important information about the epidemiology of the disease but is incomplete both in terms of geographic coverage and data availability. Expanding surveillance to additional states could help identify emerging areas that pose a risk for locally acquired infections. In Arizona and California, where most cases occur, collecting systematic enhanced data, such as more detailed patient characteristics and disease severity, could help clarify the reasons behind the recent changes in incidence and identify additional opportunities for focused prevention and educational efforts. |
Molecular typing of clinical and environmental isolates of Cryptococcus gattii species complex from Southern California, United States.
Hurst S , Lysen C , Cooksey G , Vugia DJ , Litvintseva AP , Lockhart SR . Mycoses 2019 62 (11) 1029-1034 BACKGROUND: Two species complexes (SC) cause the majority of human Cryptococcus infections: Cryptococcus neoformans SC and Cryptococcus gattii SC. Infection is typically thought to be acquired following environmental exposure. In an urban setting, parks and other public spaces are a likely source of contact with C. gattii SC. OBJECTIVES: The goals of this study were to describe the genetic diversity of C. gattii SC in the California environment, to determine the extent of environmental exposure in publicly accessed areas, and to correlate the genotypes of environmental C. gattii SC isolates with those from patients in Southern California. METHODS: Specimens from trees and soil from 13 parks and public areas of seven California counties were examined for C. gattii SC isolates. Isolates were sequence typed and compared to sequence types from human clinical isolates from the same area. RESULTS: Multilocus sequence typing identified C. gattii sensu stricto (VGI molecular type) as well as C. bacillisporus (VGIII molecular type). Several C. bacillisporus but none of the C. gattii sensu stricto isolates shared sequence types with human clinical isolates from Southern California. CONCLUSIONS: C. gattii SC colonies exist in some California public parks. The presence of identical STs in environmental and human isolates of C. bacillisporus is suggestive of an arboreal origin of human infections. Two new tree species were documented as hosts for C. gattii SC in California, adding to the four species previously identified. This article is protected by copyright. All rights reserved. |
Update on the Epidemiology of coccidioidomycosis in the United States.
McCotter OZ , Benedict K , Engelthaler DM , Komatsu K , Lucas KD , Mohle-Boetani JC , Oltean H , Vugia D , Chiller TM , Sondermeyer Cooksey GL , Nguyen A , Roe CC , Wheeler C , Sunenshine R . Med Mycol 2019 57 S30-s40 The incidence of reported coccidioidomycosis in the past two decades has increased greatly; monitoring its changing epidemiology is essential for understanding its burden on patients and the healthcare system and for identifying opportunities for prevention and education. We provide an update on recent coccidioidomycosis trends and public health efforts nationally and in Arizona, California, and Washington State. In Arizona, enhanced surveillance shows that coccidioidomycosis continues to be associated with substantial morbidity. California reported its highest yearly number of cases ever in 2016 and has implemented interventions to reduce coccidioidomycosis in the prison population by excluding certain inmates from residing in prisons in high-risk areas. Coccidioidomycosis is emerging in Washington State, where phylogenetic analyses confirm the existence of a unique Coccidioides clade. Additional studies of the molecular epidemiology of Coccidioides will improve understanding its expanding endemic range. Ongoing public health collaborations and future research priorities are focused on characterizing geographic risk, particularly in the context of environmental change; identifying further risk reduction strategies for high-risk groups; and improving reporting of cases to public health agencies. |
Occupational coccidioidomycosis surveillance and recent outbreaks in California
de Perio MA , Materna BL , Sondermeyer Cooksey GL , Vugia DJ , Su CP , Luckhaupt SE , McNary J , Wilken JA . Med Mycol 2019 57 S41-s45 Workers in Coccidioides-endemic areas performing soil-disturbing work or exposed to windy and dusty conditions are at increased risk for coccidioidomycosis. Four occupational coccidioidomycosis outbreaks from 2007 to 2014 in California are described, involving construction workers in a number of excavation projects and an outdoor filming event involving cast and crew. These outbreaks highlight the importance of identifying industries and occupations at high risk for coccidioidomycosis, conducting targeted occupational health surveillance to assess the burden of illness, developing and implementing prevention strategies, and setting research priorities. |
Coccidioidomycosis outbreak among workers constructing a solar power farm - Monterey County, California, 2016-2017
Laws RL , Cooksey GS , Jain S , Wilken J , McNary J , Moreno E , Michie K , Mulkerin C , McDowell A , Vugia D , Materna B . MMWR Morb Mortal Wkly Rep 2018 67 (33) 931-934 In January 2017, two local health departments notified the California Department of Public Health (CDPH) of three cases of coccidioidomycosis among workers constructing a solar power installation (solar farm) in southeastern Monterey County. Coccidioidomycosis, or Valley fever, is an infection caused by inhalation of the soil-dwelling fungus Coccidioides, which is endemic in the southwestern United States, including California. After a 1-3 week incubation period, coccidioidomycosis most often causes influenza-like symptoms or pneumonia, but rarely can lead to severe disseminated disease or death (1). Persons living, working, or traveling in areas where Coccidioides is endemic can inhale fungal spores; workers who are performing soil-disturbing activities are particularly at risk. CDPH previously investigated one outbreak among solar farm construction workers that started in 2011 and made recommendations for reducing risk for infection, including worker education, dust suppression, and use of personal protective equipment (2,3). For the current outbreak, the CDPH, in collaboration with Monterey County and San Luis Obispo County public health departments, conducted an investigation that identified nine laboratory-confirmed cases of coccidioidomycosis among 2,410 solar farm employees and calculated a worksite-specific incidence rate that was substantially higher than background county rates, suggesting that illness was work-related. The investigation assessed risk factors for potential occupational exposures to identify methods to prevent further workplace illness. |
Notes from the field: Increase in coccidioidomycosis - California, 2016
Cooksey GS , Nguyen A , Knutson K , Tabnak F , Benedict K , McCotter O , Jain S , Vugia D . MMWR Morb Mortal Wkly Rep 2017 66 (31) 833-834 Coccidioidomycosis, or Valley Fever, is an infectious disease caused by inhalation of Coccidioides spp. spores. This soil-dwelling fungus is endemic in the southwestern United States, with most (97%) U.S. cases reported from Arizona and California. Following an incubation period of 1-3 weeks, symptomatic patients most often experience self-limited, influenza-like symptoms, but coccidioidomycosis also can lead to severe pulmonary disease and to rare cases of disseminated disease, including meningitis. Those at increased risk for severe disease include persons of African or Filipino descent, pregnant women, adults in older age groups, and persons with weakened immune systems. In 2016, a large increase in coccidioidomycosis incidence was observed in California compared with previous years. Using data reported by health care providers and laboratories via local health departments to the California Department of Public Health as of May 9, 2017, incidence rates were calculated by estimated year of illness onset as the number of confirmed coccidioidomycosis cases per 100,000 population. Estimated year of illness onset was extracted from the closest date to the time when symptoms first appeared for each patient. From 1995, when coccidioidomycosis became an individually reportable disease in California, to 2009, annual incidence rates ranged from 1.9 to 8.4 per 100,000, followed by a substantial increase to 11.9 per 100,000 in 2010 and a peak of 13.8 per 100,000 in 2011 (Figure). Annual rates decreased during 2012-2014, but increased in 2016 to 13.7 per 100,000, with 5,372 reported cases, the highest annual number of cases in California recorded to date. |
Dust exposure and coccidioidomycosis prevention among solar power farm construction workers in California
Sondermeyer Cooksey GL , Wilken JA , McNary J , Gilliss D , Shusterman D , Materna BL , Vugia DJ . Am J Public Health 2017 107 (8) e1-e8 OBJECTIVES: To investigate if work activities, dust exposure, and protection measures were associated with a 2011 to 2014 coccidioidomycosis outbreak among workers constructing 2 solar farms in California. METHODS: In 2013, we mailed self-administered questionnaires to employees who were onsite at the solar farms where the outbreak occurred to identify cases of clinical coccidioidomycosis and compare with asymptomatic workers by using multivariate logistic regression. RESULTS: When we compared 89 workers with clinical coccidioidomycosis to 325 asymptomatic workers, frequently being in a dust cloud or storm (odds ratio [OR] = 5.93; 95% confidence interval [CI] = 3.18, 11.06) significantly increased the odds of clinical coccidioidomycosis, whereas frequently wetting soil before soil-disturbing activity (OR = 0.42; 95% CI = 0.24, 0.75) was protective. When we controlled for being in a dust cloud or storm, frequent soil disturbance significantly increased the odds of clinical coccidioidomycosis only among those who reported wearing a respirator infrequently (OR = 2.31; 95% CI = 1.27, 4.21). CONCLUSIONS: Utilization of personal and employer-driven safety practices and increased coccidioidomycosis awareness among construction workers should be considered during the planning of any construction work in coccidioidomycosis-endemic regions to prevent occupational infections and outbreaks. (Am J Public Health. Published online ahead of print June 22, 2017: e1-e8. doi:10.2105/AJPH.2017.303820). |
Team-based care and improved blood pressure control: a Community Guide systematic review
Proia KK , Thota AB , Njie GJ , Finnie RK , Hopkins DP , Mukhtar Q , Pronk NP , Zeigler D , Kottke TE , Rask KJ , Lackland DT , Brooks JF , Braun LT , Cooksey T . Am J Prev Med 2014 47 (1) 86-99 CONTEXT: Uncontrolled hypertension remains a widely prevalent cardiovascular risk factor in the U.S. team-based care, established by adding new staff or changing the roles of existing staff such as nurses and pharmacists to work with a primary care provider and the patient. Team-based care has the potential to improve the quality of hypertension management. The goal of this Community Guide systematic review was to examine the effectiveness of team-based care in improving blood pressure (BP) outcomes. EVIDENCE ACQUISITION: An existing systematic review (search period, January 1980-July 2003) assessing team-based care for BP control was supplemented with a Community Guide update (January 2003-May 2012). For the Community Guide update, two reviewers independently abstracted data and assessed quality of eligible studies. EVIDENCE SYNTHESIS: Twenty-eight studies in the prior review (1980-2003) and an additional 52 studies from the Community Guide update (2003-2012) qualified for inclusion. Results from both bodies of evidence suggest that team-based care is effective in improving BP outcomes. From the update, the proportion of patients with controlled BP improved (median increase=12 percentage points); systolic BP decreased (median reduction=5.4 mmHg); and diastolic BP also decreased (median reduction=1.8 mmHg). CONCLUSIONS: Team-based care increased the proportion of people with controlled BP and reduced both systolic and diastolic BP, especially when pharmacists and nurses were part of the team. Findings are applicable to a range of U.S. settings and population groups. Implementation of this multidisciplinary approach will require health system-level organizational changes and could be an important element of the medical home. |
Molecular identification of mutations associated with anti-tuberculosis drug resistance among strains of Mycobacterium tuberculosis
Abbadi SH , Sameaa GA , Morlock G , Cooksey RC . Int J Infect Dis 2009 13 (6) 673-8 BACKGROUND: Understanding the etiologic organism, antimicrobial resistance mechanisms, and transmission of multidrug-resistant tuberculosis (MDR-TB) can be of great value in optimizing strategies to control and prevent its development and transmission. METHODS: One hundred and fifty-five Mycobacterium tuberculosis complex isolates from patients with pulmonary tuberculosis (TB) in Cairo, Egypt were studied. In vitro drug susceptibility testing against rifampin (RIF), isoniazid (INH), streptomycin (SM), ethambutol (EMB), and pyrazinamide (PZA) was performed. Resistance was studied by the standard agar proportion method. Single strand conformation polymorphism (SSCP) and DNA sequence analysis were used to detect mutations in the genes that encode resistance to rpoB, katG, rpsL, and embB. RESULTS: Among 155 consecutive M. tuberculosis isolates, 25 (16.1%) were MDR-TB; 13 of these were from newly diagnosed untreated cases, 12 were from re-treated cases, and none of the MDR-TB isolates had matching IS6110 fingerprints. Among the MDR-TB isolates, rpoB mutations were found in 76% of RIF-resistant isolates, katG mutations were found in 47.1% of INH-resistant isolates, rpsL mutations were found in 55.6% of SM-resistant isolates, and embB mutations were found in 36.4% of EMB-resistant isolates. CONCLUSIONS: No major differences were found in the frequencies of mutations or types of amino acid substitution between newly diagnosed untreated cases and re-treated cases. The high prevalence of MDR-TB at this hospital underscores the need for continuous monitoring of strains and antimicrobial resistance. |
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