Shigellosis outbreak among persons experiencing homelessness-San Diego County, California, October-December 2021.

During October 2021, the County of San Diego Health and Human Services Agency identified five cases of shigellosis among persons experiencing homelessness (PEH). We conducted an outbreak investigation and developed interventions to respond to shigellosis outbreaks among PEH. Confirmed cases occurred among PEH with stool-cultured ; probable cases were among PEH with -positive culture-independent diagnostic testing.

FOCUS Program: Treating Patients With Cancer and Family Caregivers as a Unit of Care.

Background: Studies indicate that patients' and caregivers' responses to illness are interdependent; each person affects the other. Existing evidence reinforces the need to recognize family caregivers as equal recipients of care and support.

Objectives: This evidence-based pilot study evaluated the feasibility and preliminary efficacy of the nurse-guided, psychoeducational, family-based FOCUS program intervention at a local oncology outpatient clinic.

Homelessness and Hepatitis A-San Diego County, 2016-2018.

Background: Hepatitis A is a vaccine-preventable viral disease transmitted by the fecal-oral route. During 2016-2018, the County of San Diego investigated an outbreak of hepatitis A infections primarily among people experiencing homelessness (PEH) to identify risk factors and support control measures. At the time of the outbreak, homelessness was not recognized as an independent risk factor for the disease.

Shiga Toxin 1-Producing Shigella sonnei Infections, California, United States, 2014-2015.

Shiga toxins (Stx) are primarily associated with Shiga toxin-producing Escherichia coli and Shigella dysenteriae serotype 1. Stx production by other shigellae is uncommon, but in 2014, Stx1-producing S. sonnei infections were detected in California.

Two Listeria monocytogenes Pseudo-outbreaks Caused by Contaminated Laboratory Culture Media.

Listeriosis is a serious foodborne infection that disproportionately affects elderly adults, pregnant women, newborns, and immunocompromised individuals. Diagnosis is made by culturing Listeria monocytogenes from sterile body fluids or from products of conception. This report describes the investigations of two listeriosis pseudo-outbreaks caused by contaminated laboratory media made from sheep blood.

The first cases of 2009 pandemic influenza A (H1N1) virus infection in the United States: a serologic investigation demonstrating early transmission.

Background: The first two laboratory-confirmed cases of 2009 pandemic influenza A (H1N1) virus (H1N1pdm09) infection were detected in San Diego (SD) and Imperial County (IC) in southern California, April 2009.

Objectives: To describe H1N1pdm09 infections and transmission early in the 2009 H1N1 pandemic.

Patients/methods: We identified index case-patients from SD and IC with polymerase chain reaction (PCR)-confirmed H1N1pdm09 infections and investigated close contacts for a subset of case-patients from April 17-May 6, 2009.

Transmission of 2009 pandemic influenza A (H1N1) virus among healthcare personnel-Southern California, 2009.

Objective: In April 2009, 2009 pandemic influenza A (H1N1) (hereafter, pH1N1) virus was identified in California, which caused widespread illness throughout the United States. We evaluated pH1N1 transmission among exposed healthcare personnel (HCP) and assessed the use and effectiveness of personal protective equipment (PPE) early in the outbreak.

Design: Cohort study.

Spatial and temporal clustering of Kawasaki syndrome cases.

Background: The etiology of Kawasaki syndrome (KS) remains unknown despite 30 years of intensive search for an agent. Epidemiologic clues to a possible infectious etiology include the seasonal distribution of cases, the previous occurrence of epidemics, the clinical features of the syndrome that mimic other infectious rash/fever illnesses in children, the self-limited nature of the illness, and the peak age incidence in the toddler years.

Methods: We examined the epidemiology and spatial and temporal distribution of KS cases in San Diego County, California during the 6-year period from 1998 to 2003.

Delayed diagnosis by physicians contributes to the development of coronary artery aneurysms in children with Kawasaki syndrome.

Background: A diagnosis of Kawasaki syndrome is based on clinical criteria with nonspecific laboratory findings, and there is a substantial risk of coronary artery aneurysms if treatment with intravenous immunoglobulin is delayed. In this study, we examined the contributions of sociodemographic factors and parent and physician behavior to the development of coronary artery aneurysms in children with Kawasaki syndrome.

Methods: We performed a retrospective, case-control chart review of Kawasaki syndrome patients treated at our institution during an 11-year period (1991-2002).

Familial occurrence of Kawasaki syndrome in North America.

Objective: To describe families with multiple members affected with Kawasaki syndrome (KS) to increase awareness of the familial occurrence of KS among practitioners who care for these patients.

Design: Retrospective review of medical records at 2 medical centers and data collection from remote KS families who contacted the KS Research Program at the University of California, San Diego.

Results: Eighteen families with multiple affected members were identified.

Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features.

Background: Acute disseminated encephalomyelitis (ADEM) is a central nervous system demyelinating disease that usually follows an apparently benign infection in otherwise healthy young persons. The epidemiology, infectious antecedents and pathogenesis of ADEM are poorly characterized, and some ADEM patients are subsequently diagnosed with multiple sclerosis (MS).

Methods: We retrospectively (1991-1998) and prospectively (1998-2000) studied all persons aged < 20 years diagnosed with ADEM from the 3 principal pediatric hospitals in San Diego County, CA, during 1991-2000.

Rapidly growing mycobacterial infections after pedicures.

Background: Rapidly growing mycobacteria (RGM) can cause a variety of cutaneous and systemic diseases. The causative organisms are typically Mycobacterium fortuitum or Mycobacterium chelonae (also known as Mycobacterium abscessus). Primary cutaneous lesions may develop after a variable latent period, from weeks to several months, and usually result from direct inoculation after trauma, from injections, or during surgery via contaminated medical instruments.