Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Su CP [original query] |
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Measles outbreak at a privately operated detention facility: Arizona, 2016
Venkat H , Briggs G , Brady S , Komatsu K , Hill C , Leung J , Patel M , Livar E , Su CP , Kassem A , Sowers SB , Mercader S , Rota PA , Elson D , Timme E , Robinson S , Fitzpatrick K , Franco J , Hickman C , Gastanaduy PA . Clin Infect Dis 2019 68 (12) 2018-2025 BACKGROUND: We describe a measles outbreak and control measures implemented at a privately operated detention facility housing US Immigration and Customs Enforcement detainees in 2016. METHODS: Case-patients reported fever and rash and were either laboratory-confirmed or had an epidemiological link to a laboratory-confirmed case-patient. Immunoglobulin G (IgG) avidity and plaque reduction neutralization tests distinguished between primary acute and reinfection case-patients. Measles-specific IgG was measured to assess detainee immunity levels. We compared attack rates (ARs) among detainees and staff, between IgG-negative and IgG-positive detainees, and by detainee housing units and sexes. RESULTS: We identified 32 measles case-patients (23 detainees, 9 staff); rash onsets were during 6 May-26 June 2016. High IgG avidity and neutralizing-antibody titers >40000 to measles (indicating reinfection) were identified in 18 (95%) and 15 (84%) of 19 tested case-patients, respectively. Among 205 unit A detainees tested for presumptive immunity, 186 (91%) had detectable IgG. Overall, the AR was 1.65%. ARs were significantly higher among detainees in unit A (7.05%) compared with units B-F (0.59%), and among male (2.33%) compared with female detainees (0.38%); however, ARs were not significantly different between detainees and staff or between IgG-negative and IgG-positive detainees. Control measures included the vaccination of 1424 of 1425 detainees and 190 of 510 staff, immunity verification for 445 staff, case-patient isolation, and quarantine of affected units. CONCLUSIONS: Although ARs were low, measles outbreaks can occur in intense-exposure settings, despite a high population immunity, underscoring the importance of high vaccination coverage and containment in limiting measles transmission. |
Workplace secondhand tobacco smoke exposure among U.S. nonsmoking workers, 2015
Su CP , Syamlal G , Tamers S , Li J , Luckhaupt SE . MMWR Morb Mortal Wkly Rep 2019 68 (27) 604-607 Secondhand tobacco smoke (SHS) exposure contributes to ill health and disease, including heart disease, lung cancer, and stroke (1). Although cigarette smoking has declined among U.S. workers, workplace exposure to SHS remains high, particularly among workers in certain industries, such as construction (2,3). Implementation of smoke-free laws has proven to be beneficial in reducing SHS exposure in general (1). CDC analyzed data from the 2015 National Health Interview Survey (NHIS) Occupational Health Supplement to assess the prevalence of self-reported workplace SHS exposure among nonsmoking workers by smoke-free policy status in the workers' states of residence and in detailed industry categories and subcategories. In 2015, 19.9% of nonsmoking workers reported any exposure to SHS at work during the 12 months preceding the interview, and 10.1% reported frequent exposure (twice a week or more). Nonsmoking workers who resided in states with comprehensive smoke-free laws in all three categories of venues (private worksites, bars, and restaurants) were least likely to report frequent exposure to workplace SHS. Nonsmoking workers employed in the commercial and industrial machinery and equipment repair and maintenance industry reported the highest prevalences of any workplace SHS exposure (65.1%), whereas the construction industry had the highest reported number of exposed workers (2.9 million); these industry categories/subcategories include outdoor workplaces and other settings that are unlikely to be protected by smoke-free laws. Identifying specific at-risk workplaces and implementing targeted intervention strategies could help reduce SHS exposure at work and protect workers' health. |
Case investigations of infectious diseases occurring in workplaces, United States, 2006-2015
Su CP , de Perio MA , Cummings KJ , McCague AB , Luckhaupt SE , Sweeney MH . Emerg Infect Dis 2019 25 (3) 397-405 Workers in specific settings and activities are at increased risk for certain infectious diseases. When an infectious disease case occurs in a worker, investigators need to understand the mechanisms of disease propagation in the workplace. Few publications have explored these factors in the United States; a literature search yielded 66 investigations of infectious disease occurring in US workplaces during 2006-2015. Reported cases appear to be concentrated in specific industries and occupations, especially the healthcare industry, laboratory workers, animal workers, and public service workers. A hierarchy-of-controls approach can help determine how to implement effective preventive measures in workplaces. Consideration of occupational risk factors and control of occupational exposures will help prevent disease transmission in the workplace and protect workers' health. |
Health insurance coverage among U.S. workers: Differences by work arrangements in 2010 and 2015
Su CP , Asfaw A , Tamers SL , Luckhaupt SE . Am J Prev Med 2019 56 (5) 673-679 INTRODUCTION: For most Americans, health insurance is obtained through employers. Health insurance coverage can lead to better health outcomes, yet disparities in coverage exist among workers with different sociodemographic and job characteristics. This study compared uninsured rates among workers with different work arrangements. METHODS: Data from the 2010 and 2015 National Health Interview Survey-Occupational Health Supplements were used to capture a representative sample of the U.S. civilian, non-institutionalized population. Associations between work arrangement and lack of health insurance were analyzed, adjusting for covariates. Analyses were performed during 2016-2018. RESULTS: The percentage of workers aged 18-64years without health insurance coverage decreased significantly by 6.8% among workers in all work arrangement categories between 2010 and 2015. However, workers in nonstandard work arrangements were still more likely than standard workers to have no health insurance coverage. In 2015, for workers to have no health insurance the ORs were 4.92 (95% CI=3.91, 6.17) in independent, 2.87 (95% CI=2.00, 4.12) in temporary or contract, and 2.79 (95% CI=0.34, 0.41) in other work arrangements. Standard full-time workers in small establishments and standard part-time workers were also more likely to have no health insurance coverage (OR=2.74, 95% CI=2.27, 3.31, and OR=1.65, 95% CI=1.25, 2.18, respectively). CONCLUSIONS: Important disparities in health insurance coverage among workers with different work arrangements existed in 2010 and persisted in 2015. Further research is needed to monitor coverage trends among workers. |
Occupational coccidioidomycosis surveillance and recent outbreaks in California
de Perio MA , Materna BL , Sondermeyer Cooksey GL , Vugia DJ , Su CP , Luckhaupt SE , McNary J , Wilken JA . Med Mycol 2019 57 S41-s45 Workers in Coccidioides-endemic areas performing soil-disturbing work or exposed to windy and dusty conditions are at increased risk for coccidioidomycosis. Four occupational coccidioidomycosis outbreaks from 2007 to 2014 in California are described, involving construction workers in a number of excavation projects and an outdoor filming event involving cast and crew. These outbreaks highlight the importance of identifying industries and occupations at high risk for coccidioidomycosis, conducting targeted occupational health surveillance to assess the burden of illness, developing and implementing prevention strategies, and setting research priorities. |
Occupational animal exposure among persons with campylobacteriosis and cryptosporidiosis - Nebraska, 2005-2015
Su CP , Stover DT , Buss BF , Carlson AV , Luckhaupt SE . MMWR Morb Mortal Wkly Rep 2017 66 (36) 955-958 Campylobacter and Cryptosporidium are two common causes of gastroenteritis in the United States. National incidence rates measured for these pathogens in 2015 were 17.7 and 3.0 per 100,000 population, respectively; Nebraska was among the states with the highest incidence for both campylobacteriosis (26.6) and cryptosporidiosis (≥6.01) (1). Although campylobacteriosis and cryptosporidiosis are primarily transmitted via consumption of contaminated food or water, they can also be acquired through contact with live animals or animal products, including through occupational exposure (2). This exposure route is of particular interest in Nebraska, where animal agriculture and associated industries are an important part of the state's economy. To estimate the percentage of disease that might be related to occupational animal exposure in Nebraska, the Nebraska Department of Health and Human Services (NDHHS) and CDC reviewed deidentified investigation reports from 2005 to 2015 of cases of campylobacteriosis and cryptosporidiosis among Nebraska residents aged ≥14 years. Case investigation notes were searched for evidence of occupational animal exposures, which were classified into discrete categories based on industry, animal/meat, and specific work activity/exposure. Occupational animal exposure was identified in 16.6% of 3,352 campylobacteriosis and 8.7% of 1,070 cryptosporidiosis cases, among which animal production (e.g., farming or ranching) was the most commonly mentioned industry type (68.2% and 78.5%, respectively), followed by employment in animal slaughter and processing facilities (16.3% and 5.4%, respectively). Among animal/meat occupational exposures, cattle/beef was most commonly mentioned, with exposure to feedlots (concentrated animal feeding operations in which animals are fed on stored feeds) reported in 29.9% of campylobacteriosis and 7.9% of cryptosporidiosis cases. Close contact with animals and manure in feedlots and other farm settings might place workers in these areas at increased risk for infection. It is important to educate workers with occupational animal exposure about the symptoms of enteric diseases and prevention measures. Targeting prevention strategies to high-risk workplaces and activities could help reduce disease. |
Occupational distribution of Campylobacteriosis and Salmonellosis cases - Maryland, Ohio, and Virginia, 2014
Su CP , de Perio MA , Fagan K , Smith ML , Salehi E , Levine S , Gruszynski K , Luckhaupt SE . MMWR Morb Mortal Wkly Rep 2017 66 (32) 850-853 Campylobacter and Salmonella are leading causes of bacterial gastroenteritis in the United States and are estimated to cause >1 million episodes of domestically acquired illness annually. Campylobacter and Salmonella are primarily transmitted through contaminated food, but animal-to-human and human-to-human transmission can also occur. Although occupationally acquired infections have been reported, occupational risk factors have rarely been studied. In 2015, the Occupational Safety and Health Administration (OSHA) identified 63 suspected or confirmed cases of Campylobacter infection over 3.5 years at a poultry-processing plant (Kathleen Fagan, OSHA, personal communication, December 2015); most involved new workers handling chickens in the "live hang" area where bacterial contamination is likely to be the highest. These findings were similar to those of a previous study of Campylobacter infections among workers at another poultry-processing plant (4). The investigation led to discussions among OSHA, state health departments, and CDC's National Institute for Occupational Safety and Health (NIOSH); and a surveillance study was initiated to further explore the disease incidence in poultry-processing plant workers and identify any additional occupations at increased risk for common enteric infections. Deidentified reports of campylobacteriosis and salmonellosis among Maryland, Ohio, and Virginia residents aged ≥16 years were obtained and reviewed. Each employed patient was classified into one of 23 major occupational groups using the 2010 Standard Occupational Classification (SOC) system.* Risk ratios (RR) and 95% confidence intervals (CI) for associations between each occupational group and each disease were calculated to identify occupations potentially at increased risk, contrasting each group with all other occupations. In 2014, a total of 2,977 campylobacteriosis and 2,259 salmonellosis cases were reported. Among the 1,772 (60%) campylobacteriosis and 1,516 (67%) salmonellosis cases in patients for whom occupational information was available, 1,064 (60%) and 847 (56%), respectively, were employed. Persons in farming, fishing, and forestry as well as health care and technical occupations were at significantly increased risk for both campylobacteriosis and salmonellosis compared with all other occupations. Targeting education and prevention strategies could help reduce disease, and improving the systematic collection of occupational information in disease surveillance systems could provide a better understanding of the extent of occupationally acquired diseases. |
Notes from the Field: Measles outbreak at a United States Immigration and Customs Enforcement facility - Arizona, May-June 2016
Venkat H , Kassem AM , Su CP , Hill C , Timme E , Briggs G , Komatsu K , Robinson S , Sunenshine R , Patel M , Elson D , Gastanaduy P , Brady S . MMWR Morb Mortal Wkly Rep 2017 66 (20) 543-544 On May 25, 2016, a detainee at a U.S. Immigration and Customs Enforcement (ICE) detention center in Arizona who had been hospitalized with fever and a generalized maculopapular rash was confirmed to have measles by real-time polymerase chain reaction (rPCR). A second case of measles in a staff member was confirmed by rPCR the next day. The privately operated, city-contracted facility housed 1,425 detainees, and employed 510 staff members, including 95 federal ICE staff and 415 contract staff of four distinct employers. Outbreak control measures consisted of administration of measles-mumps-rubella (MMR) vaccine to 1,424 detainees housed at the facility during May 29–31 and isolation of the detainee patient and any additional detainee patients identified during their remaining infectious period (until 4 days after rash onset). Recommendations were made by federal, state, and local public health partners to exclude staff members with measles-compatible symptoms as well as exposed staff members without presumptive evidence of immunity to measles.* | Epidemiologic investigations by local and state health departments and CDC identified 31 total cases of measles in 22 detainees and nine staff members, with rash onsets occurring May 6–June 26 (Figure). Initial reports of rash illness among a few detainees were attributed to varicella (chickenpox) based on clinical presentation; some detainees also reported that they did not initially seek medical attention when they became ill, likely leading to the delay in diagnosing the first few cases of measles. The median detainee patient age was 34 years (range = 19–52 years), and the median staff patient age was 41 years (range = 22–49 years). Seven of the nine ill staff members reported receipt of at least 1 dose of MMR vaccine in the past, but no vaccination records were available at the time the outbreak was recognized. Three of the nine ill staff members received 1 dose of MMR vaccine 7–13 days before becoming ill, suggesting that exposure might have occurred before sufficient immunity developed from vaccination, because the incubation period for measles ranges from 7–21 days.† On June 17 and June 21, MMR staff member vaccination clinics were conducted on-site. Two additional clinics were conducted on July 15 and July 19. Staff members were encouraged to obtain their immunization records and to bring them to the facility to be recorded. Federal personnel policies and contractual agreements that do not require staff members to be vaccinated and the initial unavailability of staff member vaccination records might have contributed to low participation in the first two staff member vaccination clinics; only 120 MMR doses were administered, and 202 (40%) staff members were still considered to not have evidence of measles immunity. |
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