Last data update: Jun 11, 2024. (Total: 46992 publications since 2009)
Records 1-18 (of 18 Records) |
Query Trace: Heiman K [original query] |
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Investigation of a multistate outbreak of Listeria monocytogenes infections linked to frozen vegetables produced at individually quick-frozen vegetable manufacturing facilities
Madad A , Heiman Marshall K , Blessington T , Hardy C , Salter M , Basler C , Conrad A , Stroika S , Luo Y , Dwarka A , Gerhardt T , Rosa Y , Cibulskas K , Rosen HE , Adcock B , Kiang D , Hutton S , Parish M , Podoski B , Patel B , Viazis S . J Food Prot 2023 86 (8) 100117 ![]() ![]() In 2016, the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and state partners investigated nine Listeria monocytogenes infections linked to frozen vegetables. The investigation began with two environmental L. monocytogenes isolates recovered from Manufacturer A, primarily a processor of frozen onions, that were a match by whole genome sequencing (WGS) to eight clinical isolates and historical onion isolates with limited collection details. Epidemiologic information, product distribution, and laboratory evidence linked suspect food items, including products sourced from Manufacturer B, also a manufacturer of frozen vegetable/fruit products, with an additional illness. The environmental isolates were obtained during investigations at Manufacturers A and B. State and federal partners interviewed ill people, analyzed shopper card data, and collected household and retail samples. Nine ill persons between 2013 and 2016 were reported in four states. Of four ill people with information available, frozen vegetable consumption was reported by three, with shopper cards confirming purchases of Manufacturer B brands. Two identified outbreak strains of L. monocytogenes (Outbreak Strain 1 and Outbreak Strain 2) were a match to environmental isolates from Manufacturer A and/or isolates from frozen vegetables recovered from open and unopened product samples sourced from Manufacturer B; the investigation resulted in extensive voluntary recalls. The close genetic relationship between isolates helped investigators determine the source of the outbreak and take steps to protect public health. This is the first known multistate outbreak of listeriosis in the United States linked to frozen vegetables and highlights the significance of sampling and WGS analyses when there is limited epidemiologic information. Additionally, this investigation emphasizes the need for further research regarding food safety risks associated with frozen foods. |
Characterizing household emergency preparedness levels for natural disasters during the COVID-19 pandemic: United States, 2020-2021
Schnall AH , Kieszak S , Heiman HJ , Bayleyegn T , Daniel J , Hanchey A , Stauber C . J Emerg Manag 2023 21 (7) 51-69 Introduction: It is vital that households are prepared for a natural disaster to help mitigate potential negative impacts. Our goal was to characterize United States household preparedness on a national level to guide next steps to better prepare for and respond to disasters during the COVID-19 pandemic. Methods: We added 10 questions to the existing Porter Novelli's ConsumerStyles surveys in fall 2020 (N = 4,548) and spring 2021 (N = 6,455) to examine factors that contribute to overall household preparedness levels. Results: Being married (odds ratio (OR), 1.2), having children in the home (OR, 1.5), and having a household income of $150,000 or more (OR, 1.2) are all associated with increased preparedness levels. Those in the Northeast are least likely to be prepared (OR, 0.8). Persons living in mobile homes, Recreational Vehicles, boats, or vans are half as likely to have preparedness plans compared to those living in single family homes (OR, 0.6). Conclusions: As a nation, there is much work to be done in terms of preparedness to reach performance measure targets of 80 percent. These data can help inform response planning and the updating of communication resources such as websites, fact sheets, and other materials to reach a wide audience of disaster epidemiologists, emergency managers, and the public. © 2023 Weston Medical Publishing. All rights reserved. |
Characterizing emergency supply kit possession in the United States during the COVID-19 pandemic - 2020-2021.
Schnall AH , Kieszak S , Hanchey A , Heiman H , Bayleyegn T , Daniel J , Stauber C . Disaster Med Public Health Prep 2022 17 1-29 BACKGROUND: In the immediate aftermath of a disaster, household members may experience lack of support services and isolation from one another. To address this, a common recommendation is to promote preparedness through the preparation of an emergency supply kit (ESK). The goal was to characterize ESK possession on a national level to help the Centers for Disease Control and Prevention (CDC) guide next steps to better prepare for and respond to disasters and emergencies at the community level. METHODS: The authors analyzed data collected through Porter Novelli's ConsumerStyles surveys in Fall 2020 (n=3,625) and Spring 2021 (n=6,455). RESULTS: ESK ownership is lacking. Overall, while most respondents believed that an ESK would help their chance of survival, only a third have one. Age, gender, education level, and region of the country were significant predictors of kit ownership in a multivariate model. In addition, there was a significant association between level of preparedness and ESK ownership. CONCLUSIONS: These data are an essential starting point in characterizing ESK ownership and can be used to help tailor public messaging, inform work with partners to increase ESK ownership, and guide future research. |
Mathematical model of thrombin generation and bleeding phenotype in Amish carriers of Factor IX:C deficiency vs. controls
Gupta S , Bravo MC , Heiman M , Nakar C , Brummel-Ziedins K , Miller CH , Shapiro A . Thromb Res 2019 182 43-50 INTRODUCTION: Factor IX:C (FIX:C) levels vary in hemophilia B carriers even in pedigrees with a unifying genetic defect. Analyzing the balance between pro-and anticoagulants might increase our understanding of carriers' bleeding potential. AIM: In this research study, we evaluated bleeding scores (BS) and a novel mathematical model of thrombin generation (TG) in Amish FIX:C deficient carriers and controls. METHODS: Blood samples and BS were obtained from post-menarchal females, including 59 carriers and 57 controls from the same extended pedigree. Factors II, V, VII, VIII, IX, X, antithrombin, tissue factor pathway inhibitor and protein C were assayed to generate mathematical models of TG in response to 5pM tissue factor (TF) and for TF+thrombomodulin. BS was based on a modification of the MCMDM-1VWD scoring system. RESULTS: Carriers had a lower mean FIX:C (68% vs. 119%), von Willebrand factor antigen (108 vs.133) and Tissue activatable fibrinolysis inhibitor (103 vs. 111) compared to controls; both groups had a similar mean BS. Carriers demonstrated significantly lower TG parameters on both mathematical models compared to controls. Carriers with FIX:C</=50% had lower TG curves than those >50% but similar BS. CONCLUSION: Thrombin generation showed significant differences between carriers and controls, between low (</=50%) and high (>50%) FIX:C carriers, and specifically in the TF+thrombomodulin model, between high FIX:C carriers and controls, although the BS were not different. |
New product, old problem(s): multistate outbreak of Salmonella Paratyphi B variant L(+) tartrate(+) infections linked to raw sprouted nut butters, October 2015
Heiman Marshall KE , Booth H , Harrang J , Lamba K , Folley A , Ching-Lee M , Hannapel E , Greene V , Classon A , Whitlock L , Shade L , Viazis S , Nguyen T , Neil KP . Epidemiol Infect 2018 147 1-6 A cluster of Salmonella Paratyphi B variant L(+) tartrate(+) infections with indistinguishable pulsed-field gel electrophoresis patterns was detected in October 2015. Interviews initially identified nut butters, kale, kombucha, chia seeds and nutrition bars as common exposures. Epidemiologic, environmental and traceback investigations were conducted. Thirteen ill people infected with the outbreak strain were identified in 10 states with illness onset during 18 July-22 November 2015. Eight of 10 (80%) ill people reported eating Brand A raw sprouted nut butters. Brand A conducted a voluntary recall. Raw sprouted nut butters are a novel outbreak vehicle, though contaminated raw nuts, nut butters and sprouted seeds have all caused outbreaks previously. Firms producing raw sprouted products, including nut butters, should consider a kill step to reduce the risk of contamination. People at greater risk for foodborne illness may wish to consider avoiding raw products containing raw sprouted ingredients. |
Protracted Outbreak of Salmonella Newport Infections Linked to Ground Beef: Possible Role of Dairy Cows - 21 States, 2016-2017.
Marshall KEH , Tewell M , Tecle S , Leeper M , Sinatra J , Kissler B , Fung A , Brown K , Wagner D , Trees E , Hise KB , Chaturvedi V , Schlater LK , Morningstar-Shaw BR , Whitlock L , Holt K , Becker K , Nichols M , Williams IT , Jhung M , Wise ME , Gieraltowski L . MMWR Morb Mortal Wkly Rep 2018 67 (15) 443-446 ![]() ![]() In January 2017, CDC identified a cluster of Salmonella enterica serotype Newport infections with isolates sharing an indistinguishable pulsed-field gel electrophoresis (PFGE) pattern, JJPX01.0010 (pattern 10), through PulseNet, the national molecular subtyping network for foodborne disease surveillance. This report summarizes the investigation by CDC, state and local health and agriculture departments, and the U.S. Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) and discusses the possible role of dairy cows as a reservoir for strains of Salmonella that persistently cause human illness. This investigation combined epidemiologic and whole genome sequencing (WGS) data to link the outbreak to contaminated ground beef; dairy cows were hypothesized to be the ultimate source of Salmonella contamination. |
An outbreak of Escherichia coli O157:H7 infections following a dairy education school field trip in Washington state, 2015
Curran KG , Heiman Marshall KE , Singh T , Doobovsky Z , Hensley J , Melius B , Whitlock L , Stevenson L , Leinbach J , Oltean H , Glover WA , Kunesh T , Lindquist S , Williams I , Nichols M . Epidemiol Infect 2017 146 (4) 1-11 On 27 April 2015, Washington health authorities identified Escherichia coli O157:H7 infections associated with dairy education school field trips held in a barn 20-24 April. Investigation objectives were to determine the magnitude of the outbreak, identify the source of infection, prevent secondary illness transmission and develop recommendations to prevent future outbreaks. Case-finding, hypothesis generating interviews, environmental site visits and a case-control study were conducted. Parents and children were interviewed regarding event activities. Odds ratios (OR) and 95% confidence intervals (CI) were computed. Environmental testing was conducted in the barn; isolates were compared to patient isolates using pulsed-field gel electrophoresis (PFGE). Sixty people were ill, 11 (18%) were hospitalised and six (10%) developed haemolytic uremic syndrome. Ill people ranged in age from <1 year to 47 years (median: 7), and 20 (33%) were female. Twenty-seven case-patients and 88 controls were enrolled in the case-control study. Among first-grade students, handwashing (i.e. soap and water, or hand sanitiser) before lunch was protective (adjusted OR 0.13; 95% CI 0.02-0.88, P = 0.04). Barn samples yielded E. coli O157:H7 with PFGE patterns indistinguishable from patient isolates. This investigation provided epidemiological, laboratory and environmental evidence for a large outbreak of E. coli O157:H7 infections from exposure to a contaminated barn. The investigation highlights the often overlooked risk of infection through exposure to animal environments as well as the importance of handwashing for disease prevention. Increased education and encouragement of infection prevention measures, such as handwashing, can prevent illness. |
International outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder - USA and Canada, 2013-2014
Harvey RR , Heiman Marshall KE , Burnworth L , Hamel M , Tataryn J , Cutler J , Meghnath K , Wellman A , Irvin K , Isaac L , Chau K , Locas A , Kohl J , Huth PA , Nicholas D , Traphagen E , Soto K , Mank L , Holmes-Talbot K , Needham M , Barnes A , Adcock B , Honish L , Chui L , Taylor M , Gaulin C , Bekal S , Warshawsky B , Hobbs L , Tschetter LR , Surin A , Lance S , Wise ME , Williams I , Gieraltowski L . Epidemiol Infect 2017 145 (8) 1-10 Salmonella is a leading cause of bacterial foodborne illness. We report the collaborative investigative efforts of US and Canadian public health officials during the 2013-2014 international outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder. The investigation included open-ended interviews of ill persons, traceback, product testing, facility inspections, and trace forward. Ninety-four persons infected with outbreak strains from 16 states and four provinces were identified; 21% were hospitalized and none died. Fifty-four (96%) of 56 persons who consumed chia seed powder, reported 13 different brands that traced back to a single Canadian firm, distributed by four US and eight Canadian companies. Laboratory testing yielded outbreak strains from leftover and intact product. Contaminated product was recalled. Although chia seed powder is a novel outbreak vehicle, sprouted seeds are recognized as an important cause of foodborne illness; firms should follow available guidance to reduce the risk of bacterial contamination during sprouting. |
Outbreak of Escherichia coli O157:H7 infections associated with dairy education event attendance - Whatcom County, Washington, 2015
Curran K , Heiman KE , Singh T , Doobovsky Z , Hensley J , Melius B , Burnworth L , Williams I , Nichols M . MMWR Morb Mortal Wkly Rep 2015 64 (42) 1202-3 On April 27, 2015, the Whatcom County Health Department (WCHD) in Bellingham, Washington, was notified by a local laboratory regarding three children with presumptive Escherichia coli O157 infection. WCHD interviewed the parents, who indicated that all three children had attended a dairy education event held in a barn April 20-24, 2015, during a school field trip. WCHD, the Washington State Department of Health, and CDC investigated to determine the magnitude of the outbreak, identify risk factors and potential environmental sources of infection, and develop recommendations. A total of 60 cases (25 confirmed and 35 probable) were identified, and 11 patients were hospitalized. |
Escherichia coli O157 outbreaks in the United States, 2003-2012
Heiman KE , Mody RK , Johnson SD , Griffin PM , Gould LH . Emerg Infect Dis 2015 21 (8) 1293-1301 Beef and leafy vegetables were the most common sources of these outbreaks. |
Multistate outbreak of listeriosis caused by imported cheese and evidence of cross-contamination of other cheeses, USA, 2012
Heiman KE , Garalde VB , Gronostaj M , Jackson KA , Beam S , Joseph L , Saupe A , Ricotta E , Waechter H , Wellman A , Adams-Cameron M , Ray G , Fields A , Chen Y , Datta A , Burall L , Sabol A , Kucerova Z , Trees E , Metz M , Leblanc P , Lance S , Griffin PM , Tauxe RV , Silk BJ . Epidemiol Infect 2015 144 (13) 1-11 Listeria monocytogenes is a foodborne pathogen that can cause bacteraemia, meningitis, and complications during pregnancy. In July 2012, molecular subtyping identified indistinguishable L. monocytogenes isolates from six patients and two samples of different cut and repackaged cheeses. A multistate outbreak investigation was initiated. Initial analyses identified an association between eating soft cheese and outbreak-related illness (odds ratio 17.3, 95% confidence interval 2.0-825.7) but no common brand. Cheese inventory data from locations where patients bought cheese and an additional location where repackaged cheese yielded the outbreak strain were compared to identify cheeses for microbiological sampling. Intact packages of imported ricotta salata yielded the outbreak strain. Fourteen jurisdictions reported 22 cases from March-October 2012, including four deaths and a fetal loss. Six patients ultimately reported eating ricotta salata; another reported eating cheese likely cut with equipment also used for contaminated ricotta salata, and nine more reported eating other cheeses that might also have been cross-contaminated. An FDA import alert and US and international recalls followed. Epidemiology-directed microbiological testing of suspect cheeses helped identify the outbreak source. Cross-contamination of cheese highlights the importance of using validated disinfectant protocols and routine cleaning and sanitizing after cutting each block or wheel. |
Shigellosis with decreased susceptibility to azithromycin
Heiman KE , Grass JE , Sjolund-Karlsson M , Bowen A . Pediatr Infect Dis J 2014 33 (11) 1204-5 Shigella with decreased susceptibility to azithromycin (DSA-Shigella) is emerging in the United States.1 This is concerning because azithromycin is recommended for treatment of multidrug-resistant shigellosis among children and adults.2 In the United States, Shigella causes approximately 500,000 illnesses annually, mainly in children <10 years of age, and it can cause large school- and childcare-associated outbreaks.3 Because clinical guidelines for determining susceptibility of Shigella to azithromycin do not exist, DSA-Shigella isolates are difficult to identify and treatment decisions must be made without azithromycin susceptibility data. | We identified DSA-Shigella isolates through the National Antimicrobial Resistance Monitoring System (NARMS), which in 2011 began measuring azithromycin minimum inhibitory concentrations among all Shigella isolates submitted from public health laboratories to Centers for Disease Control and Prevention for routine surveillance and outbreak evaluation (∼5% of US Shigella isolates). Additional DSA-Shigella isolates were identified through NARMS retrospective studies.1 We defined DSA as azithromycin minimum inhibitory concentration >16 μg/mL using broth microdilution.1 Macrolide resistance genes mphA and ermB were detected using polymerase chain reaction. |
The influence of race and comorbidity on the timely initiation of antiretroviral therapy among older persons living with HIV/AIDS
Abara WE , Smith L , Zhang S , Fairchild AJ , Heiman HJ , Rust G . Am J Public Health 2014 104 (11) e1-e7 OBJECTIVES: We examined whether the timely initiation of antiretroviral therapy (ART) differed by race and comorbidity among older (≥ 50 years) people living with HIV/AIDS (PLWHA). METHODS: We conducted frequency and descriptive statistics analysis to characterize our sample, which we drew from 2005-2007 Medicaid claims data from 14 states. We employed univariate and multivariable Cox regression analyses to evaluate the relationship between race, comorbidity, and timely ART initiation (≤ 90 days post-HIV/AIDS diagnosis). RESULTS: Approximately half of the participants did not commence ART promptly. After we adjusted for covariates, we found that older PLWHA who reported a comorbidity were 40% (95% confidence interval = 0.26, 0.61) as likely to commence ART promptly. We found no racial differences in the timely initiation of ART among older PLWHA. CONCLUSIONS: Comorbidities affect timely ART initiation in older PLWHA. Older PLWHA may benefit from integrating and coordinating HIV care with care for other comorbidities and the development of ART treatment guidelines specific to older PLWHA. Consistent Medicaid coverage helps ensure consistent access to HIV treatment and care and may eliminate racial disparities in timely ART initiation among older PLWHA. |
National patterns of Escherichia coli O157 infections, USA, 1996-2011
Sodha SV , Heiman K , Gould LH , Bishop R , Iwamoto M , Swerdlow DL , Griffin PM . Epidemiol Infect 2014 143 (2) 1-7 US public health laboratories began reporting Escherichia coli O157 isolates to CDC in 1996. We describe temporal and geographical patterns of isolates reported from 1996 to 2011 and demographics of persons whose specimens yielded isolates. We calculated annual E. coli O157 isolation rates/100 000 persons by patient's state of residence, county of residence, age, and sex using census data. The average annual isolation rate was 0.84. The average isolation rate in northern states (1.52) was higher than in southern states (0.43). Counties with 76% rural population had a lower isolation rate (0.67) than counties with 25%, 26-50%, and 51-75% rural populations (0.81, 0.92, and 0.81, respectively). The highest isolation rate (3.19) was in children aged 1-4 years. Infections were seasonal with 49% of isolates collected during July to September. Research into reasons for higher incidence in northern states and for seasonality could guide strategies to prevent illnesses. |
Notes from the field: Shigella with decreased susceptibility to azithromycin among men who have sex with men - United States, 2002-2013
Heiman KE , Karlsson M , Grass J , Howie B , Kirkcaldy RD , Mahon B , Brooks JT , Bowen A . MMWR Morb Mortal Wkly Rep 2014 63 (6) 132-3 Bacteria of the genus Shigella cause approximately 500,000 illnesses each year in the United States. Diarrhea (sometimes bloody), fever, and stomach cramps typically start 1-2 days after exposure and usually resolve in 5-7 days. For patients with severe disease, bloody diarrhea, or compromised immune systems, antibiotic treatment is recommended, but resistance to traditional first-line antibiotics (e.g., ampicillin and trimethoprim-sulfamethoxazole) is common. For multidrugresistant cases, azithromycin, the most frequently prescribed antibiotic in the United States, is recommended for both children and adults. However, not all Shigellae are susceptible to azithromycin. Nonsusceptible isolates exist but are not usually identified because there are no clinical laboratory guidelines for azithromycin susceptibility testing. However, to monitor susceptibility of Shigellae in the United States, CDC's National Antimicrobial Resistance Monitoring System (NARMS) has, since 2011, routinely measured the azithromycin minimum inhibitory concentration (MIC) for every 20th Shigella isolate submitted from public health laboratories to CDC, as well as outbreak-associated isolates. All known U.S. Shigella isolates with decreased susceptibility to azithromycin (DSA-Shigella), and the illnesses caused by them, are described in this report. |
Binational outbreak of Guillain-Barre syndrome associated with Campylobacter jejuni infection, Mexico and USA, 2011
Jackson BR , Zegarra JA , Lopez-Gatell H , Sejvar J , Arzate F , Waterman S , Nunez AS , Lopez B , Weiss J , Cruz RQ , Murrieta DY , Luna-Gierke R , Heiman K , Vieira AR , Fitzgerald C , Kwan P , Zarate-Bermudez M , Talkington D , Hill VR , Mahon B . Epidemiol Infect 2013 142 (5) 1-11 SUMMARY: In June 2011, a cluster of suspected cases of Guillain-Barre syndrome (GBS), which can follow Campylobacter jejuni infection, was identified in San Luis Rio Colorado (SLRC), Sonora, Mexico and Yuma County, Arizona, USA. An outbreak investigation identified 26 patients (18 from Sonora, eight from Arizona) with onset of GBS 4 May-21 July 2011, exceeding the expected number of cases (n = 1-2). Twenty-one (81%) patients reported antecedent diarrhoea, and 61% of 18 patients tested were seropositive for C. jejuni IgM antibodies. In a case-control study matched on age group, sex, ethnicity, and neighbourhood of residence, all Arizona GBS patients travelled to SLRC during the exposure period vs. 45% of matched controls (matched odds ratio 8.1, 95% confidence interval 1.5-infinity). Exposure information and an environmental assessment suggested that GBS cases resulted from a large outbreak of C. jejuni infection from inadequately disinfected tap water in SLRC. Binational collaboration was essential in investigating this cross-border GBS outbreak, the first in mainland North America since 1976. |
Travel health alert notices and Haiti cholera outbreak, Florida, USA, 2011
Selent MU , McWhorter A , Beau De Rochars VM , Myers R , Hunter DW , Brown CM , Cohen NJ , Molinari NA , Warwar K , Robbins D , Heiman KE , Newton AE , Schmitz A , Oraze MJ , Marano N . Emerg Infect Dis 2011 17 (11) 2169-2171 To enhance the timeliness of medical evaluation for cholera-like illness during the 2011 cholera outbreak in Hispaniola, printed Travel Health Alert Notices (T-HANs) were distributed to travelers from Haiti to the United States. Evaluation of the T-HANs' influence on travelers' health care-seeking behavior suggested T-HANs might positively influence health care-seeking behavior. |
Cholera in United States associated with epidemic in Hispaniola
Newton AE , Heiman KE , Schmitz A , Torok T , Apostolou A , Hanson H , Gounder P , Bohm S , Kurkjian K , Parsons M , Talkington D , Stroika S , Madoff LC , Elson F , Sweat D , Cantu V , Akwari O , Mahon BE , Mintz ED . Emerg Infect Dis 2011 17 (11) 2166-2168 Cholera is rare in the United States (annual average 6 cases). Since epidemic cholera began in Hispaniola in 2010, a total of 23 cholera cases caused by toxigenic Vibrio cholerae O1 have been confirmed in the United States. Twenty-two case-patients reported travel to Hispaniola and 1 reported consumption of seafood from Haiti. |
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