Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Middaugh N[original query] |
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Wound Botulism Among Persons Who Inject Black Tar Heroin in New Mexico, 2016
Middaugh N , Edwards L , Chatham-Stephens K , Arguello DF . Front Public Health 2021 9 744179 Outbreaks of wound botulism are rare, but clinicians and health departments should maintain suspicion for signs, symptoms, and risk factors of wound botulism among persons who inject drugs in order to initiate treatment quickly. This report describes an outbreak of three wound botulism cases among persons in two adjacent counties who injected drugs. Provisional information about these cases was previously published in the CDC National Botulism Surveillance Summary. All three cases in this outbreak were laboratory-confirmed, including one case with detection of botulinum toxin type A in a wound culture sample taken 43 days after last possible heroin exposure. Findings highlight the delay in diagnosis which led to prolonged hospitalization and the persistence of botulinum toxin in one patient. |
Francisella tularensis infection in dogs: 88 cases (2014-2016)
Kwit NA , Middaugh NA , VinHatton ES , Melman SD , Onischuk L , Aragon AS , Nelson CA , Mead PS , Ettestad PJ . J Am Vet Med Assoc 2020 256 (2) 220-225 OBJECTIVE: To characterize the epidemiology, clinical signs, and treatment of dogs with Francisella tularensis infection in New Mexico. ANIMALS: 87 dogs in which 88 cases of tularemia (1 dog had 2 distinct cases) were confirmed by the New Mexico Department of Health Scientific Laboratory Division from 2014 through 2016 and for which medical records were available. PROCEDURES: Dogs were confirmed to have tularemia if they had a 4-fold or greater increase in anti-F tularensis antibody titer between acute and convalescent serum samples or F tularensis had been isolated from a clinical or necropsy specimen. Epidemiological, clinical, and treatment information were collected from the dogs' medical records and summarized. RESULTS: All 88 cases of tularemia were confirmed by paired serologic titers; the first (acute) serologic test result was negative for 84 (95%) cases. The most common reported exposure to F tularensis was wild rodent or rabbit contact (53/88 [60%]). Dogs had a median number of 3 clinical signs at initial evaluation; lethargy (81/88 [92%]), pyrexia (80/88 [91%]), anorexia (67/88 [76%]), and lymphadenopathy (18/88 [20%]) were most common. For 32 (36%) cases, the dog was hospitalized; all hospitalized dogs survived. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with F tularensis infection often had nonspecific clinical signs and developed moderate to severe illness, sometimes requiring hospitalization. Veterinarians examining dogs from tularemia-enzootic areas should be aware of the epidemiology and clinical signs of tularemia, inquire about potential exposures, and discuss prevention methods with owners, including reducing exposure to reservoir hosts and promptly seeking care for ill animals. |
Notes from the field: Adverse reaction after vaccinia virus vaccination - New Mexico, 2016
Middaugh N , Petersen B , McCollum AM , Smelser C . MMWR Morb Mortal Wkly Rep 2016 65 (47) 1351-1352 On February 4, 2016, the New Mexico Department of Health (NMDOH) was contacted regarding a patient who had received ACAM2000* smallpox (vaccinia) vaccine 12 days earlier as part of an institutional review board–approved study at a plasma donation center and had numerous lesions surrounding the inoculation site and on the opposite arm, back, and abdomen. ACAM2000 is a live-virus vaccine indicated for active immunization against smallpox. Vaccinia virus is highly effective in preventing smallpox by stimulating an immune response to the closely related Orthopoxvirus. The inoculation site is considered infectious until the scab falls off and intact skin has regrown (2–4 weeks) (1,2). The patient, a man aged 57 years, had no ocular, oral, nasal, or genital lesions. He enrolled in the study on January 22, after meeting inclusion criteria and not having a condition that precluded vaccination (immunosuppression, heart disease, or history or presence of eczema) (1). The vaccination study objective was to induce production of high antivaccinia virus antibody titers for the collection of plasma to be used in manufacturing vaccinia immune globulin intravenous (VIGIV), which is produced by removing and purifying antivaccinia antibodies from plasma of persons with immunity to smallpox. | Adverse reactions to vaccinia vaccination range from mild and self-limited to severe and life-threatening, including inoculation site signs and symptoms, constitutional symptoms, generalized vaccinia, eczema vaccinatum, and progressive vaccinia (1,3). The most frequent complication is inadvertent inoculation at other sites (self and contacts) (2–4) with an estimated occurrence rate of 42.1 cases per 1 million vaccinations (1). Autoinoculation, the unintentional transfer of virus from the vaccination site to elsewhere on the vaccinee’s body, can occur from hands or fomites; the most common nonocular transfer sites are the arm, elbow, and shoulder (2,3). Autoinoculation lesions progress through the same stages as the vaccination site lesion; when autoinoculation occurs >5 days postvaccination, lesions and progression are often attenuated (2,3). |
Pedestrian traffic deaths among residents, visitors, and homeless persons - Clark County, Nevada, 2008-2011
Hickox KL , Williams N , Beck LF , Coleman T , Fudenberg J , Robinson B , Middaugh J . MMWR Morb Mortal Wkly Rep 2014 63 (28) 597-602 Motor vehicle collisions and crashes are a leading cause of death among Nevada residents aged 5-34 years, representing 14% of all injury deaths in that age group in 2010. During 2008-2011, a total of 173 pedestrian deaths from motor vehicle collisions occurred in Nevada, accounting for 16% of motor vehicle deaths in the state (2). Approximately 75% (2 million persons) of Nevada residents live in Clark County, which includes the city of Las Vegas. To analyze pedestrian traffic deaths in Clark County among residents, visitors, and homeless persons, the Southern Nevada Health District used coroner's office data and death certificate data for the period 2008-2011. The results indicated that the average annual pedestrian traffic death rates from motor vehicle collisions during this period were 1.4 per 100,000 population for residents, 1.1 for visitors, and 30.7 for homeless persons. Among the three groups, time of day, location of motor vehicle collisions, and pedestrian blood alcohol concentration (BAC) differed. Effective interventions to increase roadway safety, such as lowering speed limits in areas with greater pedestrian traffic, targeting interventions during hours when alcohol-impaired walking is more likely, and modifying roadway designs to increase protection of pedestrians, might decrease pedestrian deaths among all three groups. |
Eight years of Legionnaires' disease transmission in travellers to a condominium complex in Las Vegas, Nevada
Silk BJ , Moore MR , Bergtholdt M , Gorwitz RJ , Kozak NA , Tha MM , Brown EW , Winchester JL , Labus BJ , Rowley P , Middaugh JP , Fields BS , Hicks LA . Epidemiol Infect 2012 140 (11) 1-10 SUMMARY: Travel is a risk factor for Legionnaires' disease. In 2008, two cases were reported in condominium guests where we investigated a 2001 outbreak. We reinvestigated to identify additional cases and determine whether ongoing transmission resulted from persistent colonization of potable water. Exposures were assessed by matched case-control analyses (2001) and case-series interviews (2008). We sampled potable water and other water sources. Isolates were compared using sequence-based typing. From 2001 to 2008, 35 cases were identified. Confirmed cases reported after the cluster in 2001-2002 were initially considered sporadic, but retrospective case-finding identified five additional cases. Cases were more likely than controls to stay in tower 2 of the condominium [matched odds ratio (mOR) 6.1, 95% confidence interval (CI) 1.6-22.9]; transmission was associated with showering duration (mOR 23.0, 95% CI 1.4-384). We characterized a clinical isolate as sequence type 35 (ST35) and detected ST35 in samples of tower 2's potable water in 2001, 2002, and 2008. This prolonged outbreak illustrates the importance of striving for permanent Legionella eradication from potable water. |
Endemic foodborne botulism among Alaska Native persons--Alaska, 1947-2007
Fagan RP , McLaughlin JB , Castrodale LJ , Gessner BD , Jenkerson SA , Funk EA , Hennessy TW , Middaugh JP , Butler JC . Clin Infect Dis 2011 52 (5) 585-92 BACKGROUND: Foodborne botulism resulting from consumption of uncooked aquatic game foods has been an endemic hazard among Alaska Native populations for centuries. Our review was conducted to help target botulism prevention and response activities. METHODS: Records of Alaska botulism investigations for the period 1947-2007 were reviewed. We used the Centers for Disease Control and Prevention case definitions for foodborne botulism and linear regression to evaluate incidence trends and chi(2) or Fisher's Exact tests to evaluate categorical data. RESULTS: A total of 317 patients (61% of whom were female) and 159 outbreaks were reported. Overall mean annual incidence was 6.9 cases per 100,000 Alaska Native persons; mean incidence was lower in 2000 (5.7 cases per 100,000 Alaska Native persons) than in any period since 1965-1969 (0.8 cases per 100,000 Alaska Native persons). Age-specific incidence was highest (26.6 cases per 100,000 Alaska Native persons) among persons aged ≥60 years. The overall case-fatality rate was 8.2%, and the case-fatality rate was ≤4.0% since 1980. Misdiagnosis was associated with a higher case-fatality rate and delayed antitoxin administration. CONCLUSIONS: Foodborne botulism remains a public health problem in Alaska. Incidence might be decreasing, but it remains >800 times the overall US rate (0.0068 cases per 100,000 persons). Prevention messages should highlight the additional risk to female individuals and older persons. Early diagnosis is critical for timely access to antitoxin and supportive care. (See the editorial commentary by Austin, on pages 593-594.) |
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