Outbreak of escherichia coli O157: H7 infections after Petting Zoo visits, North Carolina State Fair, October-November 2004.

Objectives: To identify cases, describe the outbreak, implement control measures, and identify factors associated with infection or protection from infection, including contact with animals and hand hygiene practices.

Design: Case finding, a case-control study of 45 cases and 188 controls, environmental investigation, and molecular subtyping of clinical and environmental Escherichia coli O157:H7 isolates.

Setting: The 2004 North Carolina State Fair.

Using Influenza-Like Illness Data to Reconstruct an Influenza Outbreak.

The objective of this study was to reconstruct the type A influenza epidemic that occurred in the Research Triangle Park (RTP) region of North Carolina during the 2003-04 flu season. We describe an agent-based influenza transmission model that uses Influenza-like Illness (ILI) data gathered from state agencies to estimate model parameters. The design of the model is similar to models represented in the literature that have been used to predict the impact of pandemic avian influenza in Southeast Asia and in the continental United States and to assess containment strategies.

Defining and applying a method for improving the sensitivity and specificity of an emergency department early event detection system.

The sensitivity and specificity of syndrome definitions used in early event detection (EED) systems affect the usefulness of the system for end-users. The ability to calculate these values aids system designers in the refinement of syndrome definitions to better meet public health needs. Utilizing a stratified sampling method and expert review to create a gold standard dataset for the calculation of sensitivity and specificity, we describe how varying syndrome structure impacts these statistical parameters and discuss the relevance of this to outbreak detection and investigation.

Cyclical changes in seroprevalence of leptospirosis in California sea lions: endemic and epidemic disease in one host species?

Background: Leptospirosis is a zoonotic disease infecting a broad range of mammalian hosts, and is re-emerging globally. California sea lions (Zalophus californianus) have experienced recurrent outbreaks of leptospirosis since 1970, but it is unknown whether the pathogen persists in the sea lion population or is introduced repeatedly from external reservoirs.

Methods: We analyzed serum samples collected over an 11-year period from 1344 California sea lions that stranded alive on the California coast, using the microscopic agglutination test (MAT) for antibodies to Leptospira interrogans serovar Pomona.

Use of a case-control study and geographic information systems to determine environmental and demographic risk factors for canine leptospirosis.

Leptospirosis is increasingly diagnosed as a re-emerging canine disease in the USA. Our objectives were to describe potential risk factors for canine leptospirosis infections in northern California, through the use of a case-control study, and to perform a spatial analysis to investigate which aspects of the landscape and land use patterns are important in the transmission of leptospirosis. Forty-three cases and 59 controls were enrolled into the study.

State plans for containment of pandemic influenza.

This review assesses differences and similarities of the states in planning for pandemic influenza. We reviewed the recently posted plans of 49 states for vaccination, early epidemic surveillance and detection, and intraepidemic plans for containment of pandemic influenza. All states generally follow vaccination priorities set by the Advisory Committee on Immunization Practices.