Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Gaffga NH[original query] |
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Outbreak of salmonellosis linked to live poultry from a mail-order hatchery
Gaffga NH , Barton Behravesh C , Ettestad PJ , Smelser CB , Rhorer AR , Cronquist AB , Comstock NA , Bidol SA , Patel NJ , Gerner-Smidt P , Keene WE , Gomez TM , Hopkins BA , Sotir MJ , Angulo FJ . N Engl J Med 2012 366 (22) 2065-73 BACKGROUND: Outbreaks of human salmonella infections are increasingly associated with contact with live poultry, but effective control measures are elusive. In 2005, a cluster of human salmonella Montevideo infections with a rare pattern on pulsed-field gel electrophoresis (the outbreak strain) was identified by PulseNet, a national subtyping network. METHODS: In cooperation with public health and animal health agencies, we conducted multistate investigations involving patient interviews, trace-back investigations, and environmental testing at a mail-order hatchery linked to the outbreak in order to identify the source of infections and prevent additional illnesses. A case was defined as an infection with the outbreak strain between 2004 and 2011. RESULTS: From 2004 through 2011, we identified 316 cases in 43 states. The median age of the patient was 4 years. Interviews were completed with 156 patients (or their caretakers) (49%), and 36 of these patients (23%) were hospitalized. Among the 145 patients for whom information was available, 80 (55%) had bloody diarrhea. Information on contact with live young poultry was available for 159 patients, and 122 of these patients (77%) reported having such contact. A mail-order hatchery in the western United States was identified in 81% of the trace-back investigations, and the outbreak strain was isolated from samples collected at the hatchery. After interventions at the hatchery, the number of human infections declined, but transmission continued. CONCLUSIONS: We identified a prolonged multistate outbreak of salmonellosis, predominantly affecting young children and associated with contact with live young poultry from a mail-order hatchery. Interventions performed at the hatchery reduced, but did not eliminate, associated human infections, demonstrating the difficulty of eliminating salmonella transmission from live poultry. |
Monitoring HPV type-specific prevalence over time through clinic-based surveillance: a perspective on vaccine effectiveness.
Gaffga NH , Flagg EW , Weinstock HS , Shlay JC , Ghanem KG , Koutsky LA , Kerndt PR , Hsu KK , Unger ER , Datta SD . Vaccine 2012 30 (11) 1959-64 We investigated the feasibility of monitoring trends in prevalence of vaccine-preventable human papillomavirus (HPV) types in different clinic populations. We collected cervical specimens from women presenting to family planning, primary care, and sexually transmitted disease (STD) clinics for routine pap smears in five US cities during 2003-2005. We performed HPV genotyping and calculated annual type-specific prevalences; pre-vaccine era prevalence was highest for HPV 16 (6.0; 95% confidence interval [CI] 5.5-6.6%) and annual prevalences for vaccine-preventable types were stable, with few exceptions, after controlling for clinic type, age group, and city. With sufficient sample size and stable population characteristics, clinic-based surveillance systems can contribute to monitoring HPV vaccine impact in the cervical screening population. |
The OASIS project: novel approaches to using STD surveillance data
Gaffga NH , Samuel MC , Stenger MR , Stover JA , Newman LM . Public Health Rep 2009 124 1-4 This supplemental issue of Public Health Reports presents a selection of innovative strategies designed and implemented between 1998 and 2005 to enhance the ability of public health officials to use surveillance data to monitor and respond to the epidemic of sexually transmitted diseases (STDs) in the United States. These strategies reflect the collaborative efforts of the Outcome Assessment through Systems of Integrated Surveillance (OASIS) Project workgroup, a group of public health STD epidemiologists from local and state health departments and the Centers for Disease Control and Prevention (CDC). Many of the challenges encountered in the surveillance of STDs are similar to those encountered in the surveillance and investigation of other diseases, and many of the solutions presented in this supplemental issue are generalizable to the public health practice of epidemiologists working with other diseases. |
Integration of surveillance for STDs, HIV, hepatitis, and TB: a survey of US STD control programs
Dowell D , Gaffga NH , Weinstock H , Peterman TA . Public Health Rep 2009 124 31-38 OBJECTIVES: Integration of surveillance for sexually transmitted diseases (STDs), human immunodeficiency virus (HIV), hepatitis, and tuberculosis (TB) may improve disease prevention and control. We determined the extent of surveillance integration in these programs, the benefits of integration, and barriers to increased integration. METHODS: We e-mailed a survey to the 58 federally funded local and state STD control programs and followed up with phone interviews of nine program representatives. RESULTS: The response rate was 81%. Many had compared infections by population subgroup for STDs and HIV (89%), STDs and hepatitis (53%), or STDs and TB (28%). Most (74%) had examined co-infections with HIV and STDs at the individual level and entered STD and HIV surveillance data into the same database (54%). All respondents thought some integration would be useful. Many (72%) used integrated data to disseminate information or change program strategies. The most commonly reported barriers to integration were policies preventing work with HIV data (85%) and incompatible databases (59%). CONCLUSIONS: Most STD control programs in the United States have some experience integrating surveillance data, but the degree of integration varies widely. Specific barriers to further integration were identified. The Centers for Disease Control and Prevention can help address these barriers by facilitating access to information and sharing technical solutions. Local and state programs can continue advancing surveillance integration by improving understanding of where integrated data are needed, increasing the use of available data, and pressing for appropriate and secure data sharing. |
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