During September 2023, five animal shelter workers reported developing dermatitis after contact with dry pet food bags donated by a pet store. We investigated to determine outbreak source and mitigate further spread. A case was defined as the onset of pruritus within 12 hours of contact with pet food bags or surfaces contaminated by them, occurring between September 1 and 8, 2023, in any setting. We interviewed persons presenting pruritis and requested photographs of their lesions, which a dermatologist reviewed. In total, seven cases were identified, including five among shelter workers and two among drivers who handled the pet food donation. Six (86%) persons reported contact with the exterior of donated pet food bags; all six persons who touched the unopened pet food bags experienced dermatitis. The dermatologist determined lesions were consistent with arthropod exposure. To assess arthropod contamination on the pet food bags, we adhered masking tape to their exterior and collected ≥20 samples; an entomologist examined these samples. Itch mites, Pyemotes herfsi, were present on all pet food bag samples. Although Pyemotes-associated outbreaks are rare in public health literature, practitioners can consider raising awareness of this dermatitis source.

INTRODUCTION: Asian persons in the Milwaukee, Wisconsin, area might be more susceptible to contaminant exposure because of high consumption of local sportfish and store-purchased fish. This is a particular risk to women who are pregnant or might become pregnant and breastfeeding women because of health risks to the developing fetus or child's neurological system. METHODS: We conducted a survey among women of childbearing age from 4 Asian ethnic groups (Hmong, Karen, Chinese, and Filipino) residing in the Milwaukee area to assess self-reported fish consumption from different sources, fish preparation behaviors, fish consumption behaviors during pregnancy and breastfeeding, and awareness of local and national fish consumption advisories and limits. RESULTS: Participants included 153 women aged 18 to 50 years. Seventy-one (46%) had consumed ≥1 sport-caught or store-purchased species at levels above a local, state, or federal advisory. Participants reported consuming a median of 11 Wisconsin sportfish and 24 store-purchased fish meals each year. Approximately half of participants reported reducing fish consumption or changing fish preparation methods to avoid contaminants. Overall, 62 (41%) were aware of any fish consumption advisory. CONCLUSIONS: Self-reported fish consumption habits among certain Hmong, Karen, Chinese, and Filipino women of child-bearing age were higher than local, state, or federal advisories, and approximately half of participants self-reported awareness of local or federal fish consumption advisories. Reaching Asian diaspora communities with culturally appropriate educational materials regarding safe fish consumption might help reduce contaminant exposure.

Human papillomavirus (HPV) vaccination can dramatically reduce the incidence of HPV-associated cancers. However, HPV vaccination coverage in rural areas is lower than in urban areas, and overall HPV vaccination coverage in the United States remains lower than other adolescent vaccines. We conducted 20 qualitative interviews with adolescent healthcare providers and clinic staff in urban and rural Minnesota and assessed their perspectives on HPV vaccination. Guiding interview topics included: strategies to persuade families to vaccinate their children, the impact of the patient-provider relationship and the clinical environment on vaccination uptake, and provider perceptions of parents' vaccine attitudes. In thematic analysis, all participants reported using common vaccination strategies, such as framing the HPV vaccine in terms of cancer prevention. The analysis also revealed three themes described as occurring uniquely or more intensely in rural communities than urban communities: the rural value of choice or independence, the spread of misinformation, and close-knit, multifaceted patient-provider relationships in clinical practice. Interventions aimed at increasing HPV vaccination should consider the distinctive circumstances of rural healthcare providers and patients.

BACKGROUND: The human papillomavirus (HPV) vaccine is recommended for all adolescents age 11-12 years. HPV vaccine coverage remains suboptimal in the United States though, particularly in rural areas. We surveyed adolescent immunization providers in two Midwestern states to assess rural vs. urban differences in HPV vaccine resources, practices, and attitudes. METHODS: A cross-sectional survey was sent to all licensed adolescent care providers in a subset of urban and rural counties in Minnesota and Wisconsin during 2019. Multivariable regression was used to identify attitudes and practices that differentiated rural vs. urban providers. RESULTS: There were 437 survey respondents (31% rural). Significantly fewer rural providers had evening/weekend adolescent vaccination appointments available (adjusted odds ratio (aOR) = 0.21 [95% confidence interval (CI): 0.12, 0.36]), had prior experience with adolescent vaccine quality improvement projects (aOR = 0.52 [95% CI: 0.28, 0.98]), and routinely recommended HPV vaccine during urgent/acute care visits (aOR = 0.37 [95% CI: 0.18, 0.79]). Significantly more rural providers had standing orders to administer all recommended adolescent vaccines (aOR = 2.81 [95% CI: 1.61, 4.91]) and reported giving HPV vaccine information to their patients/families before it is due (aOR = 3.10 [95% CI: 1.68, 5.71]). CONCLUSIONS: Rural vs. urban differences in provider practices were mixed in that rural providers do not implement some practices that may promote HPV vaccination, but do implement other practices that promote HPV vaccination. It remains unclear how the observed differences would affect HPV vaccine attitudes or adolescent vaccination decisions for parents in rural areas.