Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-10 (of 10 Records) |
Query Trace: Delea K [original query] |
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Contact tracing for mpox clade II cases associated with air travel - United States, July 2021-August 2022
Delea KC , Chen TH , Lavilla K , Hercules Y , Gearhart S , Preston LE , Hughes CM , Minhaj FS , Waltenburg MA , Sunshine B , Rao AK , McCollum AM , Adams K , Ocaña M , Akinkugbe O , Brown C , Alvarado-Ramy F . MMWR Morb Mortal Wkly Rep 2024 73 (35) 758-762 Monkeypox virus (MPXV) can spread among humans through direct contact with lesions, scabs, or saliva; via respiratory secretions; and indirectly from fomites; via percutaneous injuries; and by crossing the placenta to the fetus during pregnancy. Since 2022, most patients with mpox in the United States have experienced painful skin lesions, and some have had severe illness. During 2021-2022, CDC initiated aircraft contact investigations after receiving reports of travelers on commercial flights with probable or confirmed mpox during their infectious period. Data were collected 1) during 2021, when two isolated clade II mpox cases not linked to an outbreak were imported into the United States by international travelers and 2) for flights arriving in or traveling within the United States during April 30-August 2, 2022, after a global clade II mpox outbreak was detected in May 2022. A total of 113 persons (100 passengers and 13 crew members) traveled on 221 flights while they were infectious with mpox. CDC developed definitions for aircraft contacts based on proximity to mpox cases and flight duration, sent information about these contacts to U.S. health departments, and received outcome information for 1,046 (68%) of 1,538 contacts. No traveler was found to have acquired mpox via a U.S. flight exposure. For persons with mpox and their contacts who had departed from the United States, CDC forwarded contact information as well as details about the exposure event to destination countries to facilitate their own public health investigations. Findings from these aircraft contact investigations suggest that traveling on a flight with a person with mpox does not appear to constitute an exposure risk or warrant routine contact tracing activities. Nonetheless, CDC recommends that persons with mpox isolate and delay travel until they are no longer infectious. |
Predicting the environmental suitability and identifying climate and sociodemographic correlates of Guinea worm (Dracunculus Medinensis) in chad
Eneanya OA , Delea MG , Cano J , Tchindebet PO , Richards RL , Zhao Y , Meftuh A , Unterwegner K , Guagliardo SAJ , Hopkins DR , Weiss A . Am J Trop Med Hyg 2024 A comprehensive understanding of the spatial distribution and correlates of infection are key for the planning of disease control programs and assessing the feasibility of elimination and/or eradication. In this work, we used species distribution modeling to predict the environmental suitability of the Guinea worm (Dracunculus medinensis) and identify important climatic and sociodemographic risk factors. Using Guinea worm surveillance data collected by the Chad Guinea Worm Eradication Program (CGWEP) from 2010 to 2022 in combination with remotely sensed climate and sociodemographic correlates of infection within an ensemble machine learning framework, we mapped the environmental suitability of Guinea worm infection in Chad. The same analytical framework was also used to ascertain the contribution and influence of the identified climatic risk factors. Spatial distribution maps showed predominant clustering around the southern regions and along the Chari River. We also identified areas predicted to be environmentally suitable for infection. Of note are districts near the western border with Cameroon and southeastern border with Central African Republic. Key environmental correlates of infection as identified by the model were proximity to permanent rivers and inland lakes, farmlands, land surface temperature, and precipitation. This work provides a comprehensive model of the spatial distribution of Guinea worm infections in Chad 2010-2022 and sheds light on potential environmental correlates of infection. As the CGWEP moves toward elimination, the methods and results in this study will inform surveillance activities and help optimize the allocation of intervention resources. |
Slaying the serpent: A research agenda to expand intervention development and accelerate guinea worm eradication efforts
Delea MG , Sack A , Eneanya OA , Thiele E , Roy SL , Sankara D , Ijaz K , Hopkins DR , Weiss AJ . Am J Trop Med Hyg 2024 Dracunculiasis, also known as Guinea worm disease, is targeted to become the second human disease and first parasitic infection to be eradicated. The global Guinea Worm Eradication Program (GWEP), through community-based interventions, reduced the burden of disease from an estimated 3.5 million cases per year in 1986 to only 13 human cases in 2022. Despite progress, in 2012 Guinea worm disease was detected in domesticated dogs and later in domesticated cats and baboons. Without previous development of any Guinea worm therapeutics, diagnostic tests to detect pre-patent Guinea worm infection, or environmental surveillance tools, the emergence of Guinea worm disease in animal hosts-a threat to eradication-motivated an assessment of evidence gaps and research opportunities. This gap analysis informed the refinement of a robust research agenda intended to generate new evidence and identify additional tools for national GWEPs and to better align the global GWEP with a 2030 Guinea worm eradication certification target. This paper outlines the rationale for the development and expansion of the global GWEP Research Agenda and summarizes the results of the gap analysis that was conducted to identify Guinea worm-related research needs and opportunities. We describe five work streams informed by the research gap analysis that underpin the GWEP Research Agenda and address eradication endgame challenges through the employment of a systems-informed One Health approach. We also discuss the infrastructure in place to disseminate new evidence and monitor research results as well as plans for the continual review of evidence and research priorities. |
SARS-CoV-2 cases reported on international arriving and domestic flights: United States, January 2020-December 2021
Preston LE , Rey A , Dumas S , Rodriguez A , Gertz AM , Delea KC , Alvarado-Ramy F , Christensen DL , Brown C , Chen TH . Am J Public Health 2023 113 (8) e1-e5 Objectives. To describe trends in the number of air travelers categorized as infectious with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2; the virus that causes COVID-19) in the context of total US COVID-19 vaccinations administered, and overall case counts of SARS-CoV-2 in the United States. Methods. We searched the Quarantine Activity Reporting System (QARS) database for travelers with inbound international or domestic air travel, a positive SARS-CoV-2 lab result, and a surveillance categorization of SARS-CoV-2 infection reported during January 2020 to December 2021. Travelers were categorized as infectious during travel if they had arrival dates from 2 days before to 10 days after symptom onset or a positive viral test. Results. We identified 80 715 persons meeting our inclusion criteria; 67 445 persons (83.6%) had at least 1 symptom reported. Of 67 445 symptomatic passengers, 43 884 (65.1%) reported an initial symptom onset date after their flight arrival date. The number of infectious travelers mirrored the overall number of US SARS-CoV-2 cases. Conclusions. Most travelers in the study were asymptomatic during travel, and therefore unknowingly traveled while infectious. During periods of high community transmission, it is important for travelers to stay up to date with COVID-19 vaccinations and consider wearing a high-quality mask to decrease the risk of transmission. (Am J Public Health. Published online ahead of print June 15, 2023:e1-e5. https://doi.org/10.2105/AJPH.2023.307325). |
Monkeypox in a Traveler Returning from Nigeria - Dallas, Texas, July 2021.
Rao AK , Schulte J , Chen TH , Hughes CM , Davidson W , Neff JM , Markarian M , Delea KC , Wada S , Liddell A , Alexander S , Sunshine B , Huang P , Honza HT , Rey A , Monroe B , Doty J , Christensen B , Delaney L , Massey J , Waltenburg M , Schrodt CA , Kuhar D , Satheshkumar PS , Kondas A , Li Y , Wilkins K , Sage KM , Yu Y , Yu P , Feldpausch A , McQuiston J , Damon IK , McCollum AM . MMWR Morb Mortal Wkly Rep 2022 71 (14) 509-516 Monkeypox is a rare, sometimes life-threatening zoonotic infection that occurs in west and central Africa. It is caused by Monkeypox virus, an orthopoxvirus similar to Variola virus (the causative agent of smallpox) and Vaccinia virus (the live virus component of orthopoxvirus vaccines) and can spread to humans. After 39 years without detection of human disease in Nigeria, an outbreak involving 118 confirmed cases was identified during 2017-2018 (1); sporadic cases continue to occur. During September 2018-May 2021, six unrelated persons traveling from Nigeria received diagnoses of monkeypox in non-African countries: four in the United Kingdom and one each in Israel and Singapore. In July 2021, a man who traveled from Lagos, Nigeria, to Dallas, Texas, became the seventh traveler to a non-African country with diagnosed monkeypox. Among 194 monitored contacts, 144 (74%) were flight contacts. The patient received tecovirimat, an antiviral for treatment of orthopoxvirus infections, and his home required large-scale decontamination. Whole genome sequencing showed that the virus was consistent with a strain of Monkeypox virus known to circulate in Nigeria, but the specific source of the patient's infection was not identified. No epidemiologically linked cases were reported in Nigeria; no contact received postexposure prophylaxis (PEP) with the orthopoxvirus vaccine ACAM2000. |
Comparison of boiling and chlorination on the quality of stored drinking water and childhood diarrhoea in Indonesian households
Fagerli K , Trivedi KK , Sodha SV , Blanton E , Ati A , Nguyen T , Delea KC , Ainslie R , Figueroa ME , Kim S , Quick R . Epidemiol Infect 2017 145 (15) 1-9 We compared the impact of a commercial chlorination product (brand name Air RahMat) in stored drinking water to traditional boiling practices in Indonesia. We conducted a baseline survey of all households with children 1000 MPN/100 ml (RR 1.86, 95% CI 1.09-3.19) in stored water than in households without detectable E. coli. Although results suggested that Air RahMat water treatment was associated with lower E. coli contamination and diarrhoeal rates among children <5 years than water treatment by boiling, Air RahMat use remained low. |
Handling practices of fresh leafy greens in restaurants: receiving and training
Coleman E , Delea K , Everstine K , Reimann D , Ripley D . J Food Prot 2013 76 (12) 2126-31 Multiple foodborne illness outbreaks have been associated with the consumption of fresh produce. Investigations have indicated that microbial contamination throughout the farm-to-fork continuum often contributed to these outbreaks. Researchers have hypothesized that handling practices for leafy greens in restaurants may support contamination by and proliferation and amplification of pathogens that cause foodborne illness outbreaks. However, limited data are available on how workers handle leafy greens in restaurants. The purpose of this study was to collect descriptive data on handling practices of leafy greens in restaurants, including restaurant characteristics, types of leafy greens used, produce receipt, and food safety training and certification. As a federal collaborative partner with the Environmental Health Specialists Network (EHS-Net) of the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration (FDA) recommended that EHS-Net participants survey handling practices for leafy greens in restaurants. The recommendations in the FDA's Guide to Minimize Microbial Food Safety Hazards of Leafy Greens are significant to this study for comparison of the results. The survey revealed that appropriate handling procedures assist in the mitigation of other unsafe handling practices for leafy greens. These results are significant because the FDA guidance for the safe handling of leafy greens was not available until 2009, after the survey had been completed. The information provided from this study can be used to promote additional efforts that will assist in developing interventions to prevent future foodborne illness outbreaks associated with leafy greens. |
The use of public health informatics to improve environmental health practice
Coleman E , Delea K . J Environ Health 2013 76 (5) 44-45 Reliable, accurate public health information technology is essential for monitoring health and for evaluating and improving the delivery of public health practice (AbouZahr & Boerma, 2005). As the complexity and interdependencies of environmental health issues have grown, environmental health programs have begun to identify the emerging need for the integration of data from diverse sources. Environmental health agencies find it beneficial to share data not only between programs and divisions within their own departments, but also with other agencies within the state, region, and nation (Ohio Department of Health, 2011). | Fragmentation of environmental health data directly affects the ability of environmental health programs to protect the communities they serve. Currently, the enormity of available data and the paucity of usable information from the data are a paradox that often frustrates federal, state, and local environmental health officials. The barriers to accessing and using environmental health data restrict the ability of public health officials to address emerging health problems, educate decision makers and the public on the full impact of specific environmental hazards, and evaluate the effectiveness of interventions (Public Health Foundation, 1997). In order for environmental health programs to be effective and grow, the programs need reliable, timely information to make information-driven decisions, improve communication, and improve tools to analyze and present new data (Friede, Blum, & McDonald, 1995). |
Evaluating local and state food and water safety programs
Delea K . J Environ Health 2012 74 (7) 32-3 Local and state food and water safety | programs are on the frontline of food | and waterborne illness prevention. | Yet in the current economic climate, some | of these public health programs are being reduced or eliminated. Data that show the impact of these programs on public health are | crucial to policy makers faced with difficult | choices that may affect the health of the communities they serve. | The Environmental Health Specialists Network (EHS-Net) at the Centers for Disease | Control and Prevention’s (CDC’s) National | Center for Environmental Health is planning to | conduct an evaluation of local and state food | and water safety programs that will provide | these needed data. EHS-Net consists of environmental health professionals, epidemiologists, | and laboratorians who work to understand | environmental causes of food and waterborne | diseases and to improve environmental public | health practice. Food and/or water safety programs from California, Iowa, Minnesota, New | York (including New York City), Rhode Island, | and Tennessee participate in EHS-Net. |
National outbreak of salmonella serotype Saintpaul infections: importance of Texas restaurant investigations in implicating jalapeno peppers
Mody RK , Greene SA , Gaul L , Sever A , Pichette S , Zambrana I , Dang T , Gass A , Wood R , Herman K , Cantwell LB , Falkenhorst G , Wannemuehler K , Hoekstra RM , McCullum I , Cone A , Franklin L , Austin J , Delea K , Behravesh CB , Sodha SV , Yee JC , Emanuel B , Al-Khaldi SF , Jefferson V , Williams IT , Griffin PM , Swerdlow DL . PLoS One 2011 6 (2) e16579 BACKGROUND: In May 2008, PulseNet detected a multistate outbreak of Salmonella enterica serotype Saintpaul infections. Initial investigations identified an epidemiologic association between illness and consumption of raw tomatoes, yet cases continued. In mid-June, we investigated two clusters of outbreak strain infections in Texas among patrons of Restaurant A and two establishments of Restaurant Chain B to determine the outbreak's source. METHODOLOGY/PRINCIPAL FINDINGS: We conducted independent case-control studies of Restaurant A and B patrons. Patients were matched to well controls by meal date. We conducted restaurant environmental investigations and traced the origin of implicated products. Forty-seven case-patients and 40 controls were enrolled in the Restaurant A study. Thirty case-patients and 31 controls were enrolled in the Restaurant Chain B study. In both studies, illness was independently associated with only one menu item, fresh salsa (Restaurant A: matched odds ratio [mOR], 37; 95% confidence interval [CI], 7.2-386; Restaurant B: mOR, 13; 95% CI 1.3-infinity). The only ingredient in common between the two salsas was raw jalapeno peppers. Cultures of jalapeno peppers collected from an importer that supplied Restaurant Chain B and serrano peppers and irrigation water from a Mexican farm that supplied that importer with jalapeno and serrano peppers grew the outbreak strain. CONCLUSIONS/SIGNIFICANCE: Jalapeno peppers, contaminated before arrival at the restaurants and served in uncooked fresh salsas, were the source of these infections. Our investigations, critical in understanding the broader multistate outbreak, exemplify an effective approach to investigating large foodborne outbreaks. Additional measures are needed to reduce produce contamination. |
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