Genomic surveillance reveals multiple introductions of SARS-CoV-2 into Northern California.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally, with >365,000 cases in California as of 17 July 2020. We investigated the genomic epidemiology of SARS-CoV-2 in Northern California from late January to mid-March 2020, using samples from 36 patients spanning nine counties and the Grand Princess cruise ship. Phylogenetic analyses revealed the cryptic introduction of at least seven different SARS-CoV-2 lineages into California, including epidemic WA1 strains associated with Washington state, with lack of a predominant lineage and limited transmission among communities.

A Genomic Survey of SARS-CoV-2 Reveals Multiple Introductions into Northern California without a Predominant Lineage.

The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 has spread globally, resulting in >300,000 reported cases worldwide as of March 21st, 2020. Here we investigate the genetic diversity and genomic epidemiology of SARS-CoV-2 in Northern California using samples from returning travelers, cruise ship passengers, and cases of community transmission with unclear infection sources. Virus genomes were sampled from 29 patients diagnosed with COVID-19 infection from Feb 3rd through Mar 15th.

Adapting the Social-Ecological Framework for Chronic Pain Management and Successful Opioid Tapering.

Context: In 2015, Solano County's Medi-Cal insurer implemented a new policy to taper patients using high-dose opioids (≥120-mg morphine equivalent dose) to a safer level to follow best practices to address the opioid epidemic.

Objective: To evaluate the effect of the 2015 Solano County Medi-Cal prescribing policy, gain insight into the patient experience of undergoing opioid tapering, and generate hypotheses for further study.

Methods: Using a case series approach, researchers completed medical record reviews of affiliated clinical records, Solano County Vital Statistics, and California's prescription monitoring program in 2018.

Epidemiology and outcomes of adults with asthma who were hospitalized or died with 2009 pandemic influenza A (H1N1)--California, 2009.

Background: Asthma was the most common chronic condition among adults hospitalized for 2009 pandemic influenza A (H1N1) (pH1N1).

Objectives: We describe the epidemiology and factors for severe outcomes among adults with asthma who were hospitalized or died from pH1N1 in California.

Methods: We reviewed California Department of Public Health pH1N1 reports from April 23, 2009 through August 11, 2009.

An outbreak of Salmonella serotype Typhimurium infections with an unusually long incubation period.

A 1998 investigation of an outbreak of Salmonella serotype Typhimurium infections among children tasting unpasteurized milk during tours of a dairy farm demonstrated a distribution of unusually long incubation periods (median, 8 days; interquartile range [IQR], 6-14 days). Bacterial isolates were highly acid tolerant and contained genes associated with protection against destructive phagocytic reactive oxygen intermediates. We hypothesize that exposure to low-dose oral inoculum of a pathogen with these properties could have contributed to cases of non-typhoidal salmonellosis with the longest incubation period reported to the Centers for Disease Control and Prevention (CDC).

A review of adult mortality due to 2009 pandemic (H1N1) influenza A in California.

Background: While children and young adults had the highest attack rates due to 2009 pandemic (H1N1) influenza A (2009 H1N1), studies of hospitalized cases noted high fatality in older adults. We analyzed California public health surveillance data to better characterize the populations at risk for dying due to 2009 H1N1.

Methods And Findings: A case was an adult ≥20 years who died with influenza-like symptoms and laboratory results indicative of 2009 H1N1.

A novel risk factor for a novel virus: obesity and 2009 pandemic influenza A (H1N1).

Background: many critically ill patients with 2009 pandemic influenza A (H1N1) (2009 H1N1) infection were noted to be obese, but whether obesity, rather than its associated co-morbidities, is an independent risk factor for severe infection is unknown.

Methods: using public health surveillance data, we analyzed demographic and clinical characteristics of California residents hospitalized with 2009 H1N1 infection to assess whether obesity (body mass index [BMI] ≥ 30) and extreme obesity (BMI ≥ 40) were an independent risk factor for death among case patients ≥ 20 years old.

Results: during the period 20 April-11 August 2009, 534 adult case patients with 2009 H1N1 infection for whom BMI information was available were observed.

Children hospitalized with 2009 novel influenza A(H1N1) in California.

Objective: To describe clinical and epidemiologic features of 2009 novel influenza A(H1N1) in children.

Design: Analysis of data obtained from standardized report forms and medical records.

Setting: Statewide public health surveillance in California.

Factors associated with death or hospitalization due to pandemic 2009 influenza A(H1N1) infection in California.

Context: Pandemic influenza A(H1N1) emerged rapidly in California in April 2009. Preliminary comparisons with seasonal influenza suggest that pandemic 2009 influenza A(H1N1) disproportionately affects younger ages and causes generally mild disease.

Objective: To describe the clinical and epidemiologic features of pandemic 2009 influenza A(H1N1) cases that led to hospitalization or death.

The SEEDs of two gastrointestinal diseases: socioeconomic, environmental, and demographic factors related to cryptosporidiosis and giardiasis in Massachusetts.

Objectives: We assessed associations between community-level socioeconomic, demographic, and environmental characteristics, and the presence of two potentially waterborne infectious diseases, cryptosporidiosis and giardiasis, as reported to the Massachusetts Department of Public Health.

Methods: We created a series of maps showing the spatial distribution of cryptosporidiosis and giardiasis in Massachusetts (1993-2002) overall and by age, using logistic regression to analyze associations between community-level characteristics and the presence of at least one reported case of each disease. This analysis was repeated for communities with predominantly private water supplies.

Timeliness of enteric disease surveillance in 6 US states.

We reviewed timeline information for a sample of Salmonella spp., Shigella spp., Campylobacter spp.

Pneumonic tularemia on Martha's Vineyard: clinical, epidemiologic, and ecological characteristics.

Martha's Vineyard, Massachusetts, is the site of the only two recognized outbreaks of primary pneumonic tularemia in the United States. Beginning in 2000 and continuing through 2006, 59 presumed or confirmed tularemia cases have been reported from Martha's Vineyard, with more than 60% of these presumed to be due to inhalation of the agent. A joint CDC/Massachusetts Department of Public Health case-control study identified landscaping activities such as lawnmowing or brush cutting to be important risk factors.

Capacity of state and territorial health agencies to prevent foodborne illness.

The capacity of state and territorial health departments to investigate foodborne diseases was assessed by the Council of State and Territorial Epidemiologists from 2001 to 2002 with a self-administered, Web-based survey. Forty-eight health departments responded (47 states and 1 territory). The primary reason for not conducting more active case surveillance of enteric disease is lack of staff, while the primary reasons for not investigating foodborne disease outbreaks are limited staff and delayed notification of the outbreak.

Tularemia on Martha's Vineyard: seroprevalence and occupational risk.

We conducted a serosurvey of landscapers to determine if they were at increased risk for exposure to Francisella tularensis and to determine risk factors for infection. In Martha's Vineyard, Massachusetts, landscapers (n=132) were tested for anti-F. tularensis antibody and completed a questionnaire.