Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-30 (of 43 Records) |
Query Trace: Vieira A[original query] |
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Outbreak of anthrax in livestock with human occupational exposures - Minnesota, 2023
Schenk KE , Cornille K , Cater J , Vieira AR , Holzbauer S , Bye M , Scheftel J . J Agromedicine 2024 1-4 In July 2023, the Minnesota Department of Health (MDH) was notified of possible occupational exposures to anthrax during an outbreak in animals. In consultation with the Centers for Disease Control and Prevention, MDH epidemiologists created a questionnaire that assessed exposure risks and helped determine individual illness monitoring and antibiotic post-exposure prophylaxis needs. This investigation and the resources developed for it could be useful in future scenarios where there are occupational exposures to naturally occurring anthrax. |
Effect of primaquine dose on the risk of recurrence in patients with uncomplicated Plasmodium vivax: a systematic review and individual patient data meta-analysis
Commons RJ , Rajasekhar M , Edler P , Abreha T , Awab GR , Baird JK , Barber BE , Chu CS , Cui L , Daher A , Gonzalez-Ceron L , Grigg MJ , Hwang J , Karunajeewa H , Lacerda MVG , Ladeia-Andrade S , Lidia K , Llanos-Cuentas A , Longley RJ , Pereira DB , Pasaribu AP , Pukrittayakamee S , Rijal KR , Sutanto I , Taylor WRJ , Thanh PV , Thriemer K , Vieira JLF , Watson JA , Zuluaga-Idarraga LM , White NJ , Guerin PJ , Simpson JA , Price RN . Lancet Infect Dis 2023 BACKGROUND: Primaquine is used to eliminate Plasmodium vivax hypnozoites, but its optimal dosing regimen remains unclear. We undertook a systematic review and individual patient data meta-analysis to investigate the efficacy and tolerability of different primaquine dosing regimens to prevent P vivax recurrence. METHODS: For this systematic review and individual patient data meta-analysis, we searched MEDLINE, Web of Science, Embase, and Cochrane Central for prospective clinical studies of uncomplicated P vivax from endemic countries published between Jan 1, 2000, and June 8, 2023. We included studies if they had active follow-up of at least 28 days, and if they included a treatment group with daily primaquine given over multiple days, where primaquine was commenced within 7 days of schizontocidal treatment and was given alone or coadministered with chloroquine or one of four artemisinin-based combination therapies (ie, artemether-lumefantrine, artesunate-mefloquine, artesunate-amodiaquine, or dihydroartemisinin-piperaquine). We excluded studies if they were on prevention, prophylaxis, or patients with severe malaria, or if data were extracted retrospectively from medical records outside of a planned trial. For the meta-analysis, we contacted the investigators of eligible trials to request individual patient data and we then pooled data that were made available by Aug 23, 2021. We assessed the effects of total dose and duration of primaquine regimens on the rate of first P vivax recurrence between day 7 and day 180 by Cox's proportional hazards regression (efficacy analysis). The effect of primaquine daily dose on gastrointestinal symptoms on days 5-7 was assessed by modified Poisson regression (tolerability analysis). The study was registered with PROSPERO, CRD42019154470. FINDINGS: Of 226 identified studies, 23 studies with patient-level data from 6879 patients from 16 countries were included in the efficacy analysis. At day 180, the risk of recurrence was 51·0% (95% CI 48·2-53·9) in 1470 patients treated without primaquine, 19·3% (16·9-21·9) in 2569 patients treated with a low total dose of primaquine (approximately 3·5 mg/kg), and 8·1% (7·0-9·4) in 2811 patients treated with a high total dose of primaquine (approximately 7 mg/kg), regardless of primaquine treatment duration. Compared with treatment without primaquine, the rate of P vivax recurrence was lower after treatment with low-dose primaquine (adjusted hazard ratio 0·21, 95% CI 0·17-0·27; p<0·0001) and high-dose primaquine (0·10, 0·08-0·12; p<0·0001). High-dose primaquine had greater efficacy than low-dose primaquine in regions with high and low relapse periodicity (ie, the time from initial infection to vivax relapse). 16 studies with patient-level data from 5609 patients from ten countries were included in the tolerability analysis. Gastrointestinal symptoms on days 5-7 were reported by 4·0% (95% CI 0·0-8·7) of 893 patients treated without primaquine, 6·2% (0·5-12·0) of 737 patients treated with a low daily dose of primaquine (approximately 0·25 mg/kg per day), 5·9% (1·8-10·1) of 1123 patients treated with an intermediate daily dose (approximately 0·5 mg/kg per day) and 10·9% (5·7-16·1) of 1178 patients treated with a high daily dose (approximately 1 mg/kg per day). 20 of 23 studies included in the efficacy analysis and 15 of 16 in the tolerability analysis had a low or unclear risk of bias. INTERPRETATION: Increasing the total dose of primaquine from 3·5 mg/kg to 7 mg/kg can reduce P vivax recurrences by more than 50% in most endemic regions, with a small associated increase in gastrointestinal symptoms. FUNDING: Australian National Health and Medical Research Council, Bill & Melinda Gates Foundation, and Medicines for Malaria Venture. |
Effect of adherence to primaquine on the risk of Plasmodium vivax recurrence: a WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis
Mehdipour P , Rajasekhar M , Dini S , Zaloumis S , Abreha T , Adam I , Awab GR , Baird JK , Brasil LW , Chu CS , Cui L , Daher A , do Socorro MGomes M , Gonzalez-Ceron L , Hwang J , Karunajeewa H , Lacerda MVG , Ladeia-Andrade S , Leslie T , Ley B , Lidia K , Llanos-Cuentas A , Longley RJ , Monteiro WM , Pereira DB , Rijal KR , Saravu K , Sutanto I , Taylor WRJ , Thanh PV , Thriemer K , Vieira JLF , White NJ , Zuluaga-Idarraga LM , Guerin PJ , Price RN , Simpson JA , Commons RJ . Malar J 2023 22 (1) 306 BACKGROUND: Imperfect adherence is a major barrier to effective primaquine radical cure of Plasmodium vivax. This study investigated the effect of reduced adherence on the risk of P. vivax recurrence. METHODS: Efficacy studies of patients with uncomplicated P. vivax malaria, including a treatment arm with daily primaquine, published between January 1999 and March 2020 were identified. Individual patient data from eligible studies were pooled using standardized methodology. Adherence to primaquine was inferred from i) the percentage of supervised doses and ii) the total mg/kg dose received compared to the target total mg/kg dose per protocol. The effect of adherence to primaquine on the incidence of P. vivax recurrence between days 7 and 90 was investigated by Cox regression analysis. RESULTS: Of 82 eligible studies, 32 were available including 6917 patients from 18 countries. For adherence assessed by percentage of supervised primaquine, 2790 patients (40.3%) had poor adherence (≤ 50%) and 4127 (59.7%) had complete adherence. The risk of recurrence by day 90 was 14.0% [95% confidence interval: 12.1-16.1] in patients with poor adherence compared to 5.8% [5.0-6.7] following full adherence; p = 0.014. After controlling for age, sex, baseline parasitaemia, and total primaquine dose per protocol, the rate of the first recurrence was higher following poor adherence compared to patients with full adherence (adjusted hazard ratio (AHR) = 2.3 [1.8-2.9]). When adherence was quantified by total mg/kg dose received among 3706 patients, 347 (9.4%) had poor adherence, 88 (2.4%) had moderate adherence, and 3271 (88.2%) had complete adherence to treatment. The risks of recurrence by day 90 were 8.2% [4.3-15.2] in patients with poor adherence and 4.9% [4.1-5.8] in patients with full adherence; p < 0.001. CONCLUSION: Reduced adherence, including less supervision, increases the risk of vivax recurrence. |
The potential distribution of Bacillus anthracis suitability across Uganda using INLA.
Ndolo VA , Redding D , Deka MA , Salzer JS , Vieira AR , Onyuth H , Ocaido M , Tweyongyere R , Azuba R , Monje F , Ario AR , Kabwama S , Kisaakye E , Bulage L , Kwesiga B , Ntono V , Harris J , Wood JLN , Conlan AJK . Sci Rep 2022 12 (1) 19967 To reduce the veterinary, public health, environmental, and economic burden associated with anthrax outbreaks, it is vital to identify the spatial distribution of areas suitable for Bacillus anthracis, the causative agent of the disease. Bayesian approaches have previously been applied to estimate uncertainty around detected areas of B. anthracis suitability. However, conventional simulation-based techniques are often computationally demanding. To solve this computational problem, we use Integrated Nested Laplace Approximation (INLA) which can adjust for spatially structured random effects, to predict the suitability of B. anthracis across Uganda. We apply a Generalized Additive Model (GAM) within the INLA Bayesian framework to quantify the relationships between B. anthracis occurrence and the environment. We consolidate a national database of wildlife, livestock, and human anthrax case records across Uganda built across multiple sectors bridging human and animal partners using a One Health approach. The INLA framework successfully identified known areas of species suitability in Uganda, as well as suggested unknown hotspots across Northern, Eastern, and Central Uganda, which have not been previously identified by other niche models. The major risk factors for B. anthracis suitability were proximity to water bodies (0-0.3 km), increasing soil calcium (between 10 and 25 cmolc/kg), and elevation of 140-190 m. The sensitivity of the final model against the withheld evaluation dataset was 90% (181 out of 202 = 89.6%; rounded up to 90%). The prediction maps generated using this model can guide future anthrax prevention and surveillance plans by the relevant stakeholders in Uganda. |
What is anthrax
Bower WA , Hendricks KA , Vieira AR , Traxler RM , Weiner Z , Lynfield R , Hoffmaster A . Pathogens 2022 11 (6) Anthrax has been feared for its high mortality in animals and humans for centuries. The etiologic agent is considered a potentially devastating bioweapon, and since 1876-when Robert Koch demonstrated that Bacillus anthracis caused anthrax-it has been considered the sole cause of the disease. Anthrax is, however, a toxin-mediated disease. The toxins edema toxin and lethal toxin are formed from protein components encoded for by the pXO1 virulence plasmid present in pathogenic B. anthracis strains. However, other members of the Bacillus cereus group, to which B. anthracis belongs, have recently been shown to harbor the pXO1 plasmid and produce anthrax toxins. Infection with these Bacillus cereus group organisms produces a disease clinically similar to anthrax. This suggests that anthrax should be defined by the exotoxins encoded for by the pXO1 plasmid rather than the bacterial species it has historically been associated with, and that the definition of anthrax should be expanded to include disease caused by any member of the B. cereus group containing the toxin-producing pXO1 plasmid or anthrax toxin genes specifically. |
Modeling the ecological niche of naturally occurring anthrax at global and circumpolar extents using an ensemble modeling framework
Deka MA , Vieira AR , Bower WA . Transbound Emerg Dis 2022 69 (5) e2563-e2577 Bacillus anthracis, the causative agent of anthrax, is a spore-forming bacterium that primarily affects herbivorous livestock, wildlife, and humans exposed to direct contact with infected animal carcasses or products. To date, there are a limited number of studies that have delineated the potential global distribution of anthrax, despite the importance of the disease from both an economic and public health standpoint. This study compiled occurrence data (n = 874) of confirmed human and animal cases from 1954 to 2021 in 94 countries. Using an ensemble ecological niche model (ENM) framework, we developed updated maps of the global predicted environmental suitability of anthrax to measure relative risk at multiple scales of analysis, including a model for circumpolar regions. Additionally, we produced maps quantifying the disease transmission risk associated with anthrax to cattle, sheep, and goat populations. Environmental suitability for B. anthracis globally is concentered throughout Eurasia, sub-Saharan Africa, the Americas, Southeast Asia, Australia, and Oceania. Suitable environments for B. anthracis at the circumpolar extent extend above the Arctic Circle into portions of Russia, Canada, Iceland, Alaska, and northern Scandinavia. Environmental factors driving B. anthracis suitability globally include vegetation (EVI), land surface temperature (LST), soil characteristics, primary climate conditions, and topography. While, at the circumpolar scale, suitability is influenced by soil factors, topography, and the derived climate characteristics. The greatest risk to livestock is concentrated within the Indian Subcontinent, eastern Australia, Anatolia, the Caucasus region, Central Asia, the Balkans, Spain, Uruguay, eastern China, United States, Canada, and East Africa. This study expands on previous work that predicted the potential environmental niche of anthrax by providing enhanced knowledge on the potential spatial distribution of anthrax risk in the Southern Hemisphere, sub-Saharan Africa, Asia, and circumpolar regions of the Northern Hemisphere. We conclude that these updated maps will provide pertinent information to guide disease control programs, inform policymakers, and raise awareness at the global level to lessen morbidity and mortality among animals and humans located in environmentally suitable areas. This article is protected by copyright. All rights reserved. |
A generalizable one health framework for the control of zoonotic diseases.
Ghai RR , Wallace RM , Kile JC , Shoemaker TR , Vieira AR , Negron ME , Shadomy SV , Sinclair JR , Goryoka GW , Salyer SJ , Barton Behravesh C . Sci Rep 2022 12 (1) 8588 Effectively preventing and controlling zoonotic diseases requires a One Health approach that involves collaboration across sectors responsible for human health, animal health (both domestic and wildlife), and the environment, as well as other partners. Here we describe the Generalizable One Health Framework (GOHF), a five-step framework that provides structure for using a One Health approach in zoonotic disease programs being implemented at the local, sub-national, national, regional, or international level. Part of the framework is a toolkit that compiles existing resources and presents them following a stepwise schematic, allowing users to identify relevant resources as they are required. Coupled with recommendations for implementing a One Health approach for zoonotic disease prevention and control in technical domains including laboratory, surveillance, preparedness and response, this framework can mobilize One Health and thereby enhance and guide capacity building to combat zoonotic disease threats at the human-animal-environment interface. |
Arsenic in private well water and birth outcomes in the United States.
Bulka CM , ScannellBryan M , Lombard MA , Bartell SM , Jones DK , Bradley PM , Vieira VM , Silverman DT , Focazio M , Toccalino PL , Daniel J , Backer LC , Ayotte JD , Gribble MO , Argos M . Environ Int 2022 163 107176 BACKGROUND: Prenatal exposure to drinking water with arsenic concentrations >50g/L is associated with adverse birth outcomes, with inconclusive evidence for concentrations 50g/L. In a collaborative effort by public health experts, hydrologists, and geologists, we used published machine learning model estimates to characterize arsenic concentrations in private wells-federally unregulated for drinking water contaminants-and evaluated associations with birth outcomes throughout the conterminous U.S. METHODS: Using several machine learning models, including boosted regression trees (BRT) and random forest classification (RFC), developed from measured groundwater arsenic concentrations of 20,000 private wells, we characterized the probability that arsenic concentrations occurred within specific ranges in groundwater. Probabilistic model estimates and private well usage data were linked by county to all live birth certificates from 2016 (n=3.6 million). We evaluated associations with gestational age and term birth weight using mixed-effects models, adjusted for potential confounders and incorporated random intercepts for spatial clustering. RESULTS: We generally observed inverse associations with term birth weight. For instance, when using BRT estimates, a 10-percentage point increase in the probability that private well arsenic concentrations exceeded 5g/L was associated with a -1.83g (95% CI: -3.30, -0.38) lower term birth weight after adjusting for covariates. Similarly, a 10-percentage point increase in the probability that private well arsenic concentrations exceeded 10g/L was associated with a -2.79g (95% CI: -4.99, -0.58) lower term birth weight. Associations with gestational age were null. CONCLUSION: In this largest epidemiologic study of arsenic and birth outcomes to date, we did not observe associations of modeled arsenic estimates in private wells with gestational age and found modest inverse associations with term birth weight. Study limitations may have obscured true associations, including measurement error stemming from a lack of individual-level information on primary water sources, water arsenic concentrations, and water consumption patterns. |
Viability evaluation of freeze dried and suspension anthrax spore vaccine formulations stored at different temperatures
Abayneh T , Getachew B , Gelaye E , Traxler R , Vieira AR . Vaccine 2021 39 (42) 6245-6249 Anthrax is endemic in Ethiopia with sporadic outbreaks despite the regular vaccination of domestic livestock. This has raised concerns on the effectiveness of the vaccination strategy which may be associated with breaches in the vaccine cold chain maintenance. This study was aimed at demonstrating the tolerance of anthrax vaccine to cold chain breaches through evaluation of viable spore counts expressed as colony forming units per mL (CFU/mL) of freeze-dried and suspension anthrax vaccines stored at 5 °C, 20 °C and 37 °C for up to 6 months. Both vaccine formulations maintained above the recommended minimum required titre (2 × 10(6) culturable spores per dose for cattle, buffaloes and horses, and not <1 × 10(6) for sheep and goats) for up to 6 months at 5 °C storage. In storage at 20 °C, the viability of freeze-dried anthrax vaccine maintained the minimum required titre up to 6 months while up to 90 days in case of the suspension formulation. Both types of vaccine formulations maintained the minimum titre per dose for up to 30 days at 37 °C storage. Generally, both vaccine formulations showed similar trends in titre fall in all of the three storage temperatures (5 °C, 20 °C and 37 °C) as observed in the almost linearly overlapping 95% confidence intervals (CI) up to day 90 at 5 °C and 20 °C storages while up to day 30 at 37 °C storage. However, a significant (P < 0.05) drop in titre was observed after day 90 for storages at 5 °C and 20 °C, and after day 30 for 37 °C storage as observed in the non overlapping 95% CI from the average titres of previous time points. This study showed that if temperature excursion occurs above the recommended temperature range (4-8 °C) during storage or transport, the vaccine should remain effective and can still be used in vaccination programs. |
High prevalence of Hepatitis C Virus infection among people who use crack cocaine in an important international drug trafficking route in Central-West Region Brazil.
Castro VOL , Kamili S , Forbi JC , Stabile AC , da Silva EF , do Valle Leone de Oliveira SM , de Carvalho PRT , Puga MAM , Tanaka TSO , do Lago BV , Ibanhes ML , Araujo A , Tejada-Strop A , Lin Y , Xia GL , Sue A , Teles SA , Motta-Castro ARC . Infect Genet Evol 2020 85 104488 In this study, the prevalence rate, associated risk factors and genetic diversity of hepatitis C virus (HCV) infection were determined among people who use crack from an international drug trafficking route in Central-West, Brazil. Blood samples were collected from 700 users of crack from Campo Grande and two border cities of Mato Grosso do Sul State and tested for HCV infection using serological and molecular testing methodologies. Anti-HCV was detected in 31/700 (4.5%, 95% CI: 2.9-6.0%) and HCV RNA in 26/31 (83.9%) of anti-HCV positive samples. Phylogenetic analysis of three HCV sub-genomic regions (5'UTR, NS5B and HVR-1) revealed the circulation of 1a (73.9%), 1b (8.7%) and 3a (17.4%) genotypes. Next-generation sequencing and phylogenetic analysis of intra-host viral populations of HCV HVR-1 showed a significant variation in intra-host genetic diversity among infected individuals, with 58.8% composed of more than one sub-population. Bayesian analysis estimated that the most recent common HCV ancestor for strains identified here was introduced to this region after 1975 following expansion of intravenous drug use in Brazil. Multivariate analyses showed that only 'ever having injected drugs' was independently associated with HCV infection. These results indicate an increasing spread of multiple HCV strains requiring public health intervention, such as harm reduction, testing services and treatment among crack users in this important border region of Central Brazil. |
Potential distributions of Bacillus anthracis and Bacillus cereus biovar anthracis causing anthrax in Africa
Romero-Alvarez D , Peterson AT , Salzer JS , Pittiglio C , Shadomy S , Traxler R , Vieira AR , Bower WA , Walke H , Campbell LP . PLoS Negl Trop Dis 2020 14 (3) e0008131 BACKGROUND: Bacillus cereus biovar anthracis (Bcbva) is an emergent bacterium closely related to Bacillus anthracis, the etiological agent of anthrax. The latter has a worldwide distribution and usually causes infectious disease in mammals associated with savanna ecosystems. Bcbva was identified in humid tropical forests of Cote d'Ivoire in 2001. Here, we characterize the potential geographic distributions of Bcbva in West Africa and B. anthracis in sub-Saharan Africa using an ecological niche modeling approach. METHODOLOGY/PRINCIPAL FINDINGS: Georeferenced occurrence data for B. anthracis and Bcbva were obtained from public data repositories and the scientific literature. Combinations of temperature, humidity, vegetation greenness, and soils values served as environmental variables in model calibrations. To predict the potential distribution of suitable environments for each pathogen across the study region, parameter values derived from the median of 10 replicates of the best-performing model for each pathogen were used. We found suitable environments predicted for B. anthracis across areas of confirmed and suspected anthrax activity in sub-Saharan Africa, including an east-west corridor from Ethiopia to Sierra Leone in the Sahel region and multiple areas in eastern, central, and southern Africa. The study area for Bcbva was restricted to West and Central Africa to reflect areas that have likely been accessible to Bcbva by dispersal. Model predicted values indicated potential suitable environments within humid forested environments. Background similarity tests in geographic space indicated statistical support to reject the null hypothesis of similarity when comparing environments associated with B. anthracis to those of Bcbva and when comparing humidity values and soils values individually. We failed to reject the null hypothesis of similarity when comparing environments associated with Bcbva to those of B. anthracis, suggesting that additional investigation is needed to provide a more robust characterization of the Bcbva niche. CONCLUSIONS/SIGNIFICANCE: This study represents the first time that the environmental and geographic distribution of Bcbva has been mapped. We document likely differences in ecological niche-and consequently in geographic distribution-between Bcbva and typical B. anthracis, and areas of possible co-occurrence between the two. We provide information crucial to guiding and improving monitoring efforts focused on these pathogens. |
Zika Virus Surveillance at the Human-Animal Interface in West-Central Brazil, 2017-2018.
Pauvolid-Correa A , Goncalves Dias H , Marina Siqueira Maia L , Porfirio G , Oliveira Morgado T , Sabino-Santos G , Helena Santa Rita P , Teixeira Gomes Barreto W , Carvalho de Macedo G , Marinho Torres J , Arruda Gimenes Nantes W , Martins Santos F , Oliveira de Assis W , Castro Rucco A , Mamoru Dos Santos Yui R , Bosco Vilela Campos J , Rodrigues Leandro ESilva R , da Silva Ferreira R , Aparecido da Silva Neves N , Charlles de Souza Costa M , Ramos Martins L , Marques de Souza E , Dos Santos Carvalho M , Goncalves Lima M , de Cassia Goncalves Alves F , Humberto Guimaraes Riquelme-Junior L , Luiz Batista Figueiro L , Fernandes Gomes de Santana M , Gustavo Rodrigues Oliveira Santos L , Serra Medeiros S , Lopes Seino L , Hime Miranda E , Henrique Rezende Linhares J , de Oliveira Santos V , Almeida da Silva S , Araujo Lucio K , Silva Gomes V , de Araujo Oliveira A , Dos Santos Silva J , de Almeida Marques W , Schafer Marques M , Junior Franca de Barros J , Campos L , Couto-Lima D , Coutinho Netto C , Strussmann C , Panella N , Hannon E , Cristina de Macedo B , Ramos de Almeida J , Ramos Ribeiro K , Carolina Barros de Castro M , Pratta Campos L , Paula Rosa Dos Santos A , Marino de Souza I , de Assis Bianchini M , Helena Ramiro Correa S , Ordones Baptista Luz R , Dos Santos Vieira A , Maria de Oliveira Pinto L , Azeredo E , Tadeu Moraes Figueiredo L , Augusto Fonseca Alencar J , Maria Barbosa de Lima S , Miraglia Herrera H , Dezengrini Shlessarenko R , Barreto Dos Santos F , Maria Bispo de Filippis A , Salyer S , Montgomery J , Komar N . Viruses 2019 11 (12) Zika virus (ZIKV) was first discovered in 1947 in Uganda but was not considered a public health threat until 2007 when it found to be the source of epidemic activity in Asia. Epidemic activity spread to Brazil in 2014 and continued to spread throughout the tropical and subtropical regions of the Americas. Despite ZIKV being zoonotic in origin, information about transmission, or even exposure of non-human vertebrates and mosquitoes to ZIKV in the Americas, is lacking. Accordingly, from February 2017 to March 2018, we sought evidence of sylvatic ZIKV transmission by sampling whole blood from approximately 2000 domestic and wild vertebrates of over 100 species in West-Central Brazil within the active human ZIKV transmission area. In addition, we collected over 24,300 mosquitoes of at least 17 genera and 62 species. We screened whole blood samples and mosquito pools for ZIKV RNA using pan-flavivirus primers in a real-time reverse-transcription polymerase chain reaction (RT-PCR) in a SYBR Green platform. Positives were confirmed using ZIKV-specific envelope gene real-time RT-PCR and nucleotide sequencing. Of the 2068 vertebrates tested, none were ZIKV positive. Of the 23,315 non-engorged mosquitoes consolidated into 1503 pools tested, 22 (1.5%) with full data available showed some degree of homology to insect-specific flaviviruses. To identify previous exposure to ZIKV, 1498 plasma samples representing 62 species of domestic and sylvatic vertebrates were tested for ZIKV-neutralizing antibodies by plaque reduction neutralization test (PRNT90). From these, 23 (1.5%) of seven species were seropositive for ZIKV and negative for dengue virus serotype 2, yellow fever virus, and West Nile virus, suggesting potential monotypic reaction for ZIKV. Results presented here suggest no active transmission of ZIKV in non-human vertebrate populations or in alternative vector candidates, but suggest that vertebrates around human populations have indeed been exposed to ZIKV in West-Central Brazil. |
Salmonella serotypes: A novel measure of association with foodborne transmission
Luvsansharav UO , Vieira A , Bennett S , Huang J , Healy JM , Hoekstra RM , Bruce BB , Cole D . Foodborne Pathog Dis 2019 17 (2) 151-155 Most nontyphoidal Salmonella (NTS) illnesses in the United States are thought to be foodborne. However, transmission routes likely vary among the different serotypes. We developed a relative ranking of NTS serotypes according to the strength of their association with foodborne transmission. We used Laboratory-based Enteric Disease Surveillance data to estimate the proportion of infections for each Salmonella serotype reported from 1998 to 2015 and Foodborne Disease Outbreak Surveillance System data to calculate the proportion of foodborne outbreak-associated Salmonella illnesses caused by each serotype. We calculated the ratios of these proportions to create a foodborne relatedness (FBR) measure for each serotype. Of the top 20 serotypes, Saintpaul (2.14), Heidelberg (1.61), and Berta (1.48) had the highest FBR measures; Mississippi (0.01), Bareilly (0.13), and Paratyphi B variant L(+) tartrate(+) (0.20) had the lowest. The FBRs for the three most prevalent serotypes were 1.22 for Enteritidis, 0.77 for Typhimurium, and 1.16 for Newport. This method provides a quantitative approach to estimating the relative differences in the likelihood that an illness caused by a particular serotype was transmitted by food, which may aid in tailoring strategies to prevent Salmonella illnesses and guide future research into serotype-specific source attribution. |
The haematological consequences of Plasmodium vivax malaria after chloroquine treatment with and without primaquine: a WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis.
Commons RJ , Simpson JA , Thriemer K , Chu CS , Douglas NM , Abreha T , Alemu SG , Anez A , Anstey NM , Aseffa A , Assefa A , Awab GR , Baird JK , Barber BE , Borghini-Fuhrer I , D'Alessandro U , Dahal P , Daher A , de Vries PJ , Erhart A , Gomes MSM , Grigg MJ , Hwang J , Kager PA , Ketema T , Khan WA , Lacerda MVG , Leslie T , Ley B , Lidia K , Monteiro WM , Pereira DB , Phan GT , Phyo AP , Rowland M , Saravu K , Sibley CH , Siqueira AM , Stepniewska K , Taylor WRJ , Thwaites G , Tran BQ , Hien TT , Vieira JLF , Wangchuk S , Watson J , William T , Woodrow CJ , Nosten F , Guerin PJ , White NJ , Price RN . BMC Med 2019 17 (1) 151 BACKGROUND: Malaria causes a reduction in haemoglobin that is compounded by primaquine, particularly in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The aim of this study was to determine the relative contributions to red cell loss of malaria and primaquine in patients with uncomplicated Plasmodium vivax. METHODS: A systematic review identified P. vivax efficacy studies of chloroquine with or without primaquine published between January 2000 and March 2017. Individual patient data were pooled using standardised methodology, and the haematological response versus time was quantified using a multivariable linear mixed effects model with non-linear terms for time. Mean differences in haemoglobin between treatment groups at day of nadir and day 42 were estimated from this model. RESULTS: In total, 3421 patients from 29 studies were included: 1692 (49.5%) with normal G6PD status, 1701 (49.7%) with unknown status and 28 (0.8%) deficient or borderline individuals. Of 1975 patients treated with chloroquine alone, the mean haemoglobin fell from 12.22 g/dL [95% CI 11.93, 12.50] on day 0 to a nadir of 11.64 g/dL [11.36, 11.93] on day 2, before rising to 12.88 g/dL [12.60, 13.17] on day 42. In comparison to chloroquine alone, the mean haemoglobin in 1446 patients treated with chloroquine plus primaquine was - 0.13 g/dL [- 0.27, 0.01] lower at day of nadir (p = 0.072), but 0.49 g/dL [0.28, 0.69] higher by day 42 (p < 0.001). On day 42, patients with recurrent parasitaemia had a mean haemoglobin concentration - 0.72 g/dL [- 0.90, - 0.54] lower than patients without recurrence (p < 0.001). Seven days after starting primaquine, G6PD normal patients had a 0.3% (1/389) risk of clinically significant haemolysis (fall in haemoglobin > 25% to < 7 g/dL) and a 1% (4/389) risk of a fall in haemoglobin > 5 g/dL. CONCLUSIONS: Primaquine has the potential to reduce malaria-related anaemia at day 42 and beyond by preventing recurrent parasitaemia. Its widespread implementation will require accurate diagnosis of G6PD deficiency to reduce the risk of drug-induced haemolysis in vulnerable individuals. TRIAL REGISTRATION: This trial was registered with PROSPERO: CRD42016053312. The date of the first registration was 23 December 2016. |
Anthrax epizootic in wildlife, Bwabwata National Park, Namibia, 2017
Cossaboom CM , Khaiseb S , Haufiku B , Katjiuanjo P , Kannyinga A , Mbai K , Shuro T , Hausiku J , Likando A , Shikesho R , Nyarko K , Miller LA , Agolory S , Vieira AR , Salzer JS , Bower WA , Campbell L , Kolton CB , Marston C , Gary J , Bollweg BC , Zaki SR , Hoffmaster A , Walke H . Emerg Infect Dis 2019 25 (5) 947-950 In late September 2017, Bwabwata National Park in Namibia experienced a sudden die-off of hippopotamuses and Cape buffalo. A multiorganizational response was initiated, involving several ministries within Namibia and the US Centers for Disease Control and Prevention. Rapid interventions resulted in zero human or livestock cases associated with this epizootic. |
Prevention and control of youth camp-associated acute gastroenteritis outbreaks
Kambhampati AK , Marsh ZA , Hlavsa MC , Roberts VA , Vieira AR , Yoder JS , Hall AJ . J Pediatric Infect Dis Soc 2018 8 (5) 392-399 Background: Approximately 14 million children attend more than 14000 US camps every year. Shared accommodations and activities can facilitate acute gastroenteritis (AGE) outbreaks. Methods: We analyzed data from the National Outbreak Reporting System on US youth camp-associated AGE outbreaks that occurred between 2009 and 2016. We also conducted a systematic literature search of youth camp-associated AGE outbreaks that have occurred around the world and a gray literature search for existing recommendations on outbreak prevention and control at camps worldwide. Results: Thirty-nine US jurisdictions reported a total of 229 youth camp-associated AGE outbreaks to the National Outbreak Reporting System. Of the 226 outbreaks included in our analyses, 120 (53%) were reported to have resulted from person-to-person transmission, 42 (19%) from an unknown transmission mode, 38 (17%) from foodborne transmission, 19 (8%) from waterborne transmission, 5 (2%) from animal contact, and 2 (<1%) from environmental contamination. Among 170 (75%) outbreaks with a single suspected or confirmed etiology, norovirus (107 [63%] outbreaks), Salmonella spp (16 [9%]), and Shiga-toxin producing Escherichia coli (12 [7%]) were implicated most frequently. We identified 43 additional youth camp-associated AGE outbreaks in the literature that occurred in various countries between 1938 and 2014. Control measures identified through the literature search included camp closure, separation of ill campers, environmental disinfection, and education on food preparation and hand hygiene. Conclusions: Youth camp-associated AGE outbreaks are caused by numerous pathogens every year. These outbreaks are facilitated by factors that include improper food preparation, inadequate cleaning and disinfection, shared accommodations, and contact with animals. Health education focused on proper hygiene and preventing disease transmission could help control or prevent these outbreaks. |
The effect of chloroquine dose and primaquine on Plasmodium vivax recurrence: a WorldWide Antimalarial Resistance Network systematic review and individual patient pooled meta-analysis
Commons RJ , Simpson JA , Thriemer K , Humphreys GS , Abreha T , Alemu SG , Anez A , Anstey NM , Awab GR , Baird JK , Barber BE , Borghini-Fuhrer I , Chu CS , D'Alessandro U , Dahal P , Daher A , de Vries PJ , Erhart A , Gomes MSM , Gonzalez-Ceron L , Grigg MJ , Heidari A , Hwang J , Kager PA , Ketema T , Khan WA , Lacerda MVG , Leslie T , Ley B , Lidia K , Monteiro WM , Nosten F , Pereira DB , Phan GT , Phyo AP , Rowland M , Saravu K , Sibley CH , Siqueira AM , Stepniewska K , Sutanto I , Taylor WRJ , Thwaites G , Tran BQ , Tran HT , Valecha N , Vieira JLF , Wangchuk S , William T , Woodrow CJ , Zuluaga-Idarraga L , Guerin PJ , White NJ , Price RN . Lancet Infect Dis 2018 18 (9) 1025-1034 BACKGROUND: Chloroquine remains the mainstay of treatment for Plasmodium vivax malaria despite increasing reports of treatment failure. We did a systematic review and meta-analysis to investigate the effect of chloroquine dose and the addition of primaquine on the risk of recurrent vivax malaria across different settings. METHODS: A systematic review done in MEDLINE, Web of Science, Embase, and Cochrane Database of Systematic Reviews identified P vivax clinical trials published between Jan 1, 2000, and March 22, 2017. Principal investigators were invited to share individual patient data, which were pooled using standardised methods. Cox regression analyses with random effects for study site were used to investigate the roles of chloroquine dose and primaquine use on rate of recurrence between day 7 and day 42 (primary outcome). The review protocol is registered in PROSPERO, number CRD42016053310. FINDINGS: Of 134 identified chloroquine studies, 37 studies (from 17 countries) and 5240 patients were included. 2990 patients were treated with chloroquine alone, of whom 1041 (34.8%) received a dose below the target 25 mg/kg. The risk of recurrence was 32.4% (95% CI 29.8-35.1) by day 42. After controlling for confounders, a 5 mg/kg higher chloroquine dose reduced the rate of recurrence overall (adjusted hazard ratio [AHR] 0.82, 95% CI 0.69-0.97; p=0.021) and in children younger than 5 years (0.59, 0.41-0.86; p=0.0058). Adding primaquine reduced the risk of recurrence to 4.9% (95% CI 3.1-7.7) by day 42, which is lower than with chloroquine alone (AHR 0.10, 0.05-0.17; p<0.0001). INTERPRETATION: Chloroquine is commonly under-dosed in the treatment of vivax malaria. Increasing the recommended dose to 30 mg/kg in children younger than 5 years could reduce substantially the risk of early recurrence when primaquine is not given. Radical cure with primaquine was highly effective in preventing early recurrence and may also improve blood schizontocidal efficacy against chloroquine-resistant P vivax. FUNDING: Wellcome Trust, Australian National Health and Medical Research Council, and Bill & Melinda Gates Foundation. |
Serological evidence of Orthopoxvirus circulation among equids, southeast Brazil
Borges IA , Reynolds MG , McCollum AM , Figueiredo PO , Ambrosio LLD , Vieira FN , Costa GB , Matos ACD , de Andrade Almeida VM , Ferreira PCP , Lobato ZIP , dos Reis JKP , Kroon EG , Trindade GS . Front Microbiol 2018 9 (MAR) (402) 402 Since 1999 Vaccinia virus (VACV) outbreaks involving bovines and humans have been reported in Brazil; this zoonosis is known as Bovine Vaccinia (BV) and is mainly an occupational disease of milkers. It was only in 2008 (and then again in 2011 and 2014) however, that VACV was found causing natural infections in Brazilian equids. These reports involved only equids, no infected humans or bovines were identified, and the sources of infections remain unknown up to date. The peculiarities of Equine Vaccinia outbreaks (e.g., absence of human infection), the frequently shared environments, and fomites by equids and bovines in Brazilian farms and the remaining gaps in BV epidemiology incited a question over OPV serological status of equids in Brazil. For this report, sera from 621 equids - representing different species, ages, sexes and locations of origin within Minas Gerais State, southeast Brazil - were examined for the presence of anti-Orthopoxvirus (OPV) antibodies. Only 74 of these were sampled during an Equine Vaccinia outbreak, meaning some of these specific animals presented typical lesions of OPV infections. The majority of sera, however, were sampled from animals without typical signs of OPV infection and during the absence of reported Bovine or Equine Vaccinia outbreaks. Results suggest the circulation of VACV among equids of southeast Brazil even prior to the time of the first VACV outbreak in 2008. There is a correlation of OPVs outbreaks among bovines and equids although many gaps remain to our understanding of its nature. The data obtained may even be carefully associated to recent discussion over OPVs history. Moreover, data is available to improve the knowledge and instigate new researches regarding OPVs circulation in Brazil and worldwide. |
Enhancing surveillance and diagnostics in anthrax-endemic countries
Vieira AR , Salzer JS , Traxler RM , Hendricks KA , Kadzik ME , Marston CK , Kolton CB , Stoddard RA , Hoffmaster AR , Bower WA , Walke HT . Emerg Infect Dis 2017 23 (13) S147-53 Naturally occurring anthrax disproportionately affects the health and economic welfare of poor, rural communities in anthrax-endemic countries. However, many of these countries have limited anthrax prevention and control programs. Effective prevention of anthrax outbreaks among humans is accomplished through routine livestock vaccination programs and prompt response to animal outbreaks. The Centers for Disease Control and Prevention uses a 2-phase framework when providing technical assistance to partners in anthrax-endemic countries. The first phase assesses and identifies areas for improvement in existing human and animal surveillance, laboratory diagnostics, and outbreak response. The second phase provides steps to implement improvements to these areas. We describe examples of implementing this framework in anthrax-endemic countries. These activities are at varying stages of completion; however, the public health impact of these initiatives has been encouraging. The anthrax framework can be extended to other zoonotic diseases to build on these efforts, improve human and animal health, and enhance global health security. |
Dairy production practices and associated risks for bovine vaccinia exposure in cattle, Brazil
Borges IA , McCollum AM , Mehal JM , Haberling D , Dutra LAL , Vieira FN , Andrade LAO , Kroon EG , Holman RC , Reynolds MG , Trindade GS . New Microbes New Infect 2017 20 43-50 A cross-sectional serosurvey was performed to identify environmental features or practices of dairy farms associated with risk for exposure to vaccinia-like viruses in dairy cattle in Brazil. Sera from 103 cows from 18 farms in Minas Gerais state were examined for Orthopoxvirus-neutralizing antibodies. A database of 243 binary or multiple-selection categorical variables regarding the physical features and surrounding ecology of each property was obtained. Thirteen of 46 presumptive predictor variables were found to be significantly associated with Orthopoxvirus serostatus by univariate logistic regression methods. Use of teat sanitizer and having felids on the property were independently associated with virus exposure by multivariable analysis. Rodents have long been suspected of serving as maintenance reservoirs for vaccinia-like viruses in Brazil. Therefore, domestic felids are not only effective predators of small rodent pests, but also their urine can serve as a deterrent to rodent habitation in buildings such as stables and barns. These results corroborate previous evidence of the high significance of rodents in the Vaccinia virus transmission cycle, and they also raise questions regarding the common use of teat sanitizers in dairy production areas. Copyright © 2017 |
Outbreaks attributed to pork in the United States, 1998-2015
Self JL , Luna-Gierke RE , Fothergill A , Holt KG , Vieira AR . Epidemiol Infect 2017 145 (14) 1-11 Each year in the United States, an estimated 525 000 infections, 2900 hospitalizations, and 82 deaths are attributed to consumption of pork. We analyzed the epidemiology of outbreaks attributed to pork in the United States reported to the Centers for Disease Control and Prevention (CDC) 1998-2015. During that period, 288 outbreaks were attributed to pork, resulting in 6372 illnesses, 443 hospitalizations, and four deaths. The frequency of outbreaks attributed to pork decreased by 37% during this period, consistent with a decline in total foodborne outbreaks. However, outbreaks attributed to pork increased by 73% in 2015 (19 outbreaks) compared with the previous 3 years (average of 11 outbreaks per year), without a similar increase in total foodborne outbreaks. Most (>99%) of these outbreaks occurred among people exposed in the same state. The most frequent etiology shifted from Staphylococcus aureus toxin during 1998-2001 (19%) to Salmonella during 2012-2015 (46%). Outbreaks associated with ham decreased from eight outbreaks per year during 1998-2001, to one per year during 2012-2015 (P < 0.01). Additional efforts are necessary to reduce outbreaks and sporadic illnesses associated with pork products. |
Association between wetland presence and incidence of Salmonella enterica serotype Javiana infections in selected US sites, 2005-2011
Huang JY , Patrick ME , Manners J , Sapkota AR , Scherzinger KJ , Tobin-D'Angelo M , Henao OL , Cole DJ , Vieira AR . Epidemiol Infect 2017 145 (14) 1-7 Salmonella causes an estimated 1.2 million illnesses annually in the USA. Salmonella enterica serotype Javiana (serotype Javiana) is the fourth most common serotype isolated from humans, with the majority of illnesses occurring in southeastern states. The percentage of wetland cover by wetland type and the average incidence rates of serotype Javiana infection in selected counties of the Foodborne Disease Active Surveillance Network (FoodNet) were examined. This analysis explored the relationship between wetland environments and incidence in order to assess whether regional differences in environmental habitats may be associated with observed variations in incidence. Findings suggest that environmental habitats may support reservoirs or contribute to the persistence of serotype Javiana, and may frequently contribute to the transmission of infection compared with other Salmonella serotypes. |
Foodborne disease outbreaks in correctional institutions - United States, 1998-2014
Marlow MA , Luna-Gierke RE , Griffin PM , Vieira AR . Am J Public Health 2017 107 (7) e1-e7 OBJECTIVES: To present the first update on the epidemiology of US foodborne correctional institution outbreaks in 20 years. METHODS: We analyzed data from the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System to describe correctional institution outbreaks from 1998 to 2014 and compare them with other foodborne outbreaks. RESULTS: Two hundred foodborne outbreaks in correctional institutions were reported, resulting in 20 625 illnesses, 204 hospitalizations, and 5 deaths. Median number of outbreak-associated illnesses per 100 000 population per year was 45 (range = 11-141) compared with 7 (range = 4-10) for other outbreaks. These outbreaks accounted for 6% (20 625 of 358 330) of outbreak-associated foodborne illnesses. Thirty-seven states reported at least 1 outbreak in a correctional institution. Clostridium perfringens (28%; 36 of 128) was the most frequently reported single etiology. The most frequently reported contributing factor was food remaining at room temperature (37%; 28 of 76). CONCLUSIONS: Incarcerated persons suffer a disproportionate number of outbreak-associated foodborne illnesses. Better food safety oversight and regulation in correctional food services could decrease outbreaks. Public Health Implications. Public health officials, correctional officials, and food suppliers can work together for food safety. Clearer jurisdiction over regulation of correctional food services is needed. (Am J Public Health. Published online ahead of print May 18, 2017: e1-e7. doi:10.2105/AJPH.2017.303816). |
Challenges and persistent questions in the treatment of trichomoniasis
de Brum Vieira P , Tasca T , Secor WE . Curr Top Med Chem 2017 17 (11) 1249-1265 Trichomoniasis is a sexually transmitted disease (STD) caused by infection with the protozoan parasite Trichomonas vaginalis. It is considered the most prevalent non-viral sexually transmitted disease worldwide. Recently, the infection has been associated with adverse outcomes of pregnancy and increased risks of HIV acquisition and transmission, as well as an association with cervical and prostate cancers. The consequences of trichomoniasis are likely much greater than previously recognized, both at the individual and the community level. Since many cases are asymptomatic, and the most common approach used for diagnosis (wet mount) is also one of the least sensitive, millions of T. vaginalis infections remain undiagnosed and therefore untreated. The purpose of this review is to address what is known about the treatment of T. vaginalis infections and what additional approaches could be pursued. The increasing recognition of the potential public health implications of trichomoniasis has resulted in greater attention to improving effectiveness of the interventions for affected individuals. Currently, treatment relies almost solely on one class of drugs, the 5- nitroimidazoles, which causes concern should widespread drug resistance arise. There are also concerns regarding which 5-nitroimidazole to use as not all of them are active against T. vaginalis. Finally, new therapeutic targets and active compounds with treatment potential are considered. |
Erratum: Environmental distribution of Cryptococcus neoformans and C. gattii around the Mediterranean basin
Cogliati M , D'Amicis R , Zani A , Montagna MT , Caggiano G , De Giglio O , Balbino S , De Donno A , Serio F , Susever S , Ergin C , Velegraki A , Ellabib MS , Nardoni S , Macci C , Oliveri S , Trovato L , Dipineto L , Rickerts V , McCormick-Smith I , Akcaglar S , Tore O , Mlinaric-Missoni E , Bertout S , Mallié M , Martins MD , Vencà AC , Vieira ML , Sampaio AC , Pereira C , Criseo G , Romeo O , Ranque S , Al-Yasiri MH , Kaya M , Cerikcioglu N , Marchese A , Vezzulli L , Ilkit M , Desnos-Ollivier M , Pasquale V , Korem M , Polacheck I , Scopa A , Meyer W , Ferreira-Paim K , Hagen F , Theelen B , Boekhout T , Lockhart SR , Tintelnot K , Tortorano AM , Dromer F , Varma A , Kwon-Chung KJ , Inácio J , Alonso B , Colom MF . FEMS Yeast Res 2016 16 (7) This paper has been updated to correct a spelling error concerning an author name. It previously showed as Giuseppe Griseo, however the correct spelling is Giuseppe Criseo. |
Foodborne (1973-2013) and waterborne (1971-2013) disease outbreaks - United States
Dewey-Mattia D , Roberts VA , Vieira A , Fullerton KE . MMWR Morb Mortal Wkly Rep 2016 63 (55) 79-84 CDC collects data on foodborne and waterborne disease outbreaks reported by all U.S. states and territories through the Foodborne Disease Outbreak Surveillance System (FDOSS) (http://www.cdc.gov/foodsafety/fdoss/surveillance/index.html) and the Waterborne Disease and Outbreak Surveillance System (WBDOSS) http://www.cdc.gov/healthywater/surveillance), respectively. These two systems are the primary source of national data describing the number of reported outbreaks; outbreak-associated illnesses, hospitalizations, and deaths; etiologic agents; water source or implicated foods; settings of exposure; and other factors associated with recognized foodborne and waterborne disease outbreaks in the United States. |
Environmental distribution of Cryptococcus neoformans and Cryptococcus gattii around the Mediterranean basin
Cogliati M , D'Amicis R , Zani A , Montagna MT , Caggiano G , De Giglio O , Balbino S , De Donno A , Serio F , Susever S , Ergin C , Velegraki A , Ellabib MS , Nardoni S , Macci C , Oliveri S , Trovato L , Dipineto L , Rickerts V , McCormick-Smith I , Akcaglar S , Tore O , Mlinaric-Missoni E , Bertout S , Mallie M , Martins MD , Venca AC , Vieira ML , Sampaio AC , Pereira C , Griseo G , Romeo O , Ranque S , Al-Yasiri MH , Kaya M , Cerikcioglu N , Marchese A , Vezzulli L , Ilkit M , Desnos-Ollivier M , Pasquale V , Korem M , Polacheck I , Scopa A , Meyer W , Ferreira-Paim K , Hagen F , Theelen B , Boekhout T , Lockhart SR , Tintelnot K , Tortorano AM , Dromer F , Varma A , Kwon-Chung KJ , Inacio J , Alonso B , Colom MF . FEMS Yeast Res 2016 16 (4) In order to elucidate the distribution of Cryptococcus neoformans and C. gattii in the Mediterranean basin, an extensive environmental survey was carried out during 2012-15. A total of 302 sites located in 12 countries were sampled, 6436 samples from 3765 trees were collected, and 5% of trees were found to be colonized by cryptococcal yeasts. Cryptococcus neoformans was isolated from 177 trees and C. gattii from 13. Cryptococcus neoformans colonized 27% of Ceratonia, 10% of Olea, Platanus and Prunus trees and a lower percentage of other tree genera. The 13 C. gattii isolates were collected from five Eucalyptus, four Ceratonia, two Pinus, and two Olea trees. C. neoformans was distributed all around the Mediterranean basin, whereas C. gattii was isolated in Greece, Southern Italy, and Spain, in agreement with previous findings from both clinical and environmental sources. Among C. neoformans isolates VNI was the prevalent molecular type but VNII, VNIV and VNIII hybrid strains were also isolated. With the exception of a single VGIV isolate, all C. gattii isolates were VGI. The results confirmed the presence of both Cryptococcus species in the Mediterranean environment, and showed that both carob and olive trees represent an important niche for these yeasts. |
Attribution of Salmonella enterica serotype Hadar infections using antimicrobial resistance data from two points in the food supply system
Vieira AR , Grass J , Fedorka-Cray PJ , Plumblee JR , Tate H , Cole DJ . Epidemiol Infect 2016 144 (9) 1-8 A challenge to the development of foodborne illness prevention measures is determining the sources of enteric illness. Microbial subtyping source-attribution models attribute illnesses to various sources, requiring data characterizing bacterial isolate subtypes collected from human and food sources. We evaluated the use of antimicrobial resistance data on isolates of Salmonella enterica serotype Hadar, collected from ill humans, food animals, and from retail meats, in two microbial subtyping attribution models. We also compared model results when either antimicrobial resistance or pulsed-field gel electrophoresis (PFGE) patterns were used to subtype isolates. Depending on the subtyping model used, 68-96% of the human infections were attributed to meat and poultry food products. All models yielded similar outcomes, with 86% [95% confidence interval (CI) 80-91] to 91% (95% CI 88-96) of the attributable infections attributed to turkey, and 6% (95% CI 2-10) to 14% (95% CI 8-20) to chicken. Few illnesses (<3%) were attributed to cattle or swine. Results were similar whether the isolates were obtained from food animals during processing or from retail meat products. Our results support the view that microbial subtyping models are a flexible and robust approach for attributing Salmonella Hadar. |
Vital signs: multistate foodborne outbreaks - United States, 2010-2014
Crowe SJ , Mahon BE , Vieira AR , Gould LH . MMWR Morb Mortal Wkly Rep 2015 64 (43) 1221-5 INTRODUCTION: Millions of U.S. residents become ill from foodborne pathogens each year. Most foodborne outbreaks occur among small groups of persons in a localized area. However, because many foods are distributed widely and rapidly, and because detection methods have improved, outbreaks that occur in multiple states and that even span the entire country are being recognized with increasing frequency. METHODS: This report analyzes data from CDC's Foodborne Disease Outbreak Surveillance System to describe multistate foodborne outbreaks that occurred in the United States during 2010-2014. RESULTS: During this 5-year period, 120 multistate foodborne disease outbreaks (with identified pathogen and food or common setting) were reported to CDC. These multistate outbreaks accounted for 3% (120 of 4,163) of all reported foodborne outbreaks, but were responsible for 11% (7,929 of 71,747) of illnesses, 34% (1,460 of 4,247) of hospitalizations, and 56% (66 of 118) of deaths associated with foodborne outbreaks. Salmonella (63 outbreaks), Shiga toxin-producing E. coli (34), and Listeria monocytogenes (12) were the leading pathogens. Fruits (17), vegetable row crops (15), beef (13), sprouts (10), and seeded vegetables (nine) were the most commonly implicated foods. Traceback investigations to identify the food origin were conducted for 87 outbreaks, of which 55 led to a product recall. Imported foods were linked to 18 multistate outbreaks. CONCLUSIONS: Multistate foodborne disease outbreaks account for a disproportionate number of outbreak-associated illnesses, hospitalizations, and deaths relative to their occurrence. Working together, food industries and public health departments and agencies can develop and implement more effective ways to identify and to trace contaminated foods linked to multistate outbreaks. Lessons learned during outbreak investigations can help improve food safety practices and regulations, and might prevent future outbreaks. |
Molecular characterisation of Cryptosporidium (Apicomplexa) in children and cattle in Romania.
Vieira PM , Mederle N , Lobo ML , Imre K , Mederle O , Xiao L , Darabus G , Matos O . Folia Parasitol (Praha) 2015 62 To investigate the transmission of species of Cryptosporidium Tyzzer, 1907 in Timis County, Romania, 48 isolates of Cryptosporidium coccidia from 11 children, 29 calves and eight pigs were characterised by molecular analysis of two loci (SSU rRNA and 60-kDa glycoprotein gene). Overall, 22 isolates were amplified and sequence analyses revealed that all isolates were Cryptosporidium parvum Tyzzer, 1912. Two subtype families were identified, IIa and IId. Subtype IIdA22G1 (n = 4) was the single C. parvum subtype found in children. Subtypes found in calves included IIdA27G1 (n = 8), a novel subtype, IIdA25G1 (n = 5), IIdA22G1 (n = 2), IIdA21G1a (n = 1), and IIaA16G1R1 (n = 1). Subtype IIdA26G1 was found in a pig. These results were significantly different from previous Romanian reports, as the five subtypes of family IId identified in this study were never identified previously in this country. Thus, cattle may be a source of Cryptosporidium infections for humans and the transmission dynamics of C. parvum in Romania is more complex than previously believed. |
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