Assessing functional needs sheltering in Pike County, Kentucky: using a community assessment for public health emergency response.

Objective: During 2009-2011, Pike County, Kentucky, experienced a series of severe weather events that resulted in property damage, insufficient potable water, and need for temporary shelters. A Community Assessment for Public Health Emergency Response (CASPER) survey was implemented for future planning. CASPER assesses household health status, preparedness level, and anticipated demand for shelters.

Tightly clustered outbreak of group A streptococcal disease at a long-term care facility.

Objective: To describe investigation of a tightly clustered outbreak of invasive group A streptococcal (GAS) disease associated with a high mortality rate in a long-term care facility (LTCF).

Design: Cross-sectional carriage survey and epidemiologic investigation of LTCF resident and employee cohorts.

Setting: A 104-bed community LTCF between March 1 and April 7, 2004.

Contribution of second stool specimen to increased sensitivity of poliovirus detection in India, 1998-2000.

Acute flaccid paralysis (AFP) surveillance data from India were analysed to examine sensitivity of poliovirus isolation from stool specimens and the added sensitivity obtained from collection of a second stool specimen. Analysis was restricted to Indian AFP cases, 1998-2000, with two adequate stool specimens. The proportion of cases confirmed with wild poliovirus isolation by the second specimen only was calculated, regardless of specimen quality.

Outbreak of poliomyelitis due to type 3 poliovirus, northern India, 1999-2000: injections a major contributing factor.

Background: A large outbreak of poliomyelitis due to poliovirus type 3 (P3) occurred in India in 1999. This raised concerns about oral poliovirus vaccine (OPV) effectiveness, particularly the type 3 component, in preventing clinical disease and offered an opportunity to describe the epidemiology of a P3 outbreak.

Methods: We reviewed data collected by the National Polio Surveillance Project to describe the outbreak and conducted a case-control study to determine risk factors for the development of paralytic poliomyelitis.

Compatible poliomyelitis cases in India during 2000.

Objective: To describe the characteristics of compatible poliomyelitis cases and to assess the programmatic implications of clusters of such cases in India.

Methods: We described the characteristics of compatible poliomyelitis cases, identified clusters of compatible cases (two or more in the same district or neighbouring districts within two months), and examined their relationship to wild poliovirus cases.

Findings: There were 362 compatible cases in 2000.

Predictors of virologically confirmed poliomyelitis in India, 1998-2000.

As we progress toward eradication of polio, a growing proportion of cases of acute flaccid paralysis (AFP) reported are due to causes other than polio. AFP surveillance data from India for 1998-2000 were analyzed to determine the sensitivity and specificity of signs and symptoms present at initial case investigation and of residual weakness (which is used to classify AFP cases) for virologically confirmed poliomyelitis. Sensitivity was highest for age of <5 years (93%-97%) and residual weakness (74%-96%).

Surveillance for polio eradication: current status and lessons learnt--India, 1999.

With the launch of the Universal Immunisation Programme in India in 1985, childhood immunisation was provided to children in all districts of the country in a phased manner by 1990. Surveillance for vaccine preventable diseases (VPD) including polio was started at the same time with monthly reporting from the districts to the Ministry of Health and Family Welfare (MOHFW), Government of India (GOI). In 1995, the Pulse Polio Immunisation (PPI) campaign was launched with the objective of polio eradication.

Poliomyelitis surveillance: the model used in India for polio eradication.

Poliomyelitis surveillance in India previously involved the passive reporting of clinically suspected cases. The capacity for detecting the disease was limited because there was no surveillance of acute flaccid paralysis (AFP). In October 1997, 59 specially trained Surveillance Medical Officers were deployed throughout the country to establish active AFP surveillance; 11,533 units were created to report weekly on the occurrence of AFP cases at the district, state and national levels; timely case investigation and the collection of stool specimens from AFP cases was undertaken; linkages were made to support the polio laboratory network; and extensive training of government counterparts of the Surveillance Medical Officers was conducted.

Black Creek Canal Virus infection in Sigmodon hispidus in southern Florida.

A total of 1,500 small mammals were collected and tested for antibodies cross-reactive to Sin Nombre virus (Hantavirus: Bunyaviridae) at 89 sites in a 1,600 km2 study area of southern Florida. More than 95% of the 123 seropositive animals were cotton rats (Sigmodon hispidus), suggesting infection by Black Creek Canal Virus, although seroreactive Rattus rattus (5 of 294) and Peromyscus gossypinus (1 of 39) also were captured. Crude seroprevalence in S.

Topical antimicrobials applied to the umbilical cord stump: a new intervention against neonatal tetanus.

Background: Previous case-control studies of neonatal tetanus (NNT), a leading cause of infant mortality in developing countries, have suggested that antimicrobials applied after delivery to the umbilical cord stump may protect against this disease. However, assessment of their protective effect has been limited by the low prevalence of antimicrobial use in developing countries.

Methods: We conducted a population-based, matched, case-control study to assess the use of antimicrobials and other factors potentially related to NNT in rural parts of Bangladesh.

Outbreak of Salmonella serotype Hartford infections associated with unpasteurized orange juice.

Context: Acidic foods such as orange juice have been thought to be unlikely vehicles of foodborne illness.

Objective: To investigate an outbreak of Salmonella enterica serotype Hartford (Salmonella Hartford) infections among persons visiting a theme park in Orlando, Fla, in 1995.

Design: Review of surveillance data, matched case-control study, laboratory investigation, and environmental studies.

Vibrio vulnificus infection reporting on death certificates: the invisible impact of an often fatal infection.

This study assessed accuracy of (a) recording Vibrio vulnificus infection on death certificates and (b) International Classification of Disease (ICD)-9 codes for V. vulnificus. Patients with microbiologically confirmed V.

Vibrio Infections Associated with Raw Oyster Consumption in Florida, 1981-1994.

While the problem of raw-oyster-associated Vibrio vulnificus infection is well known, less is known about other Vibrio infections associated with raw oyster consumption. Case reports of 333 patients with raw-oyster-associated infections with V. vulnificus and other Vibrio species reported in Florida from 1981 through 1994 were reviewed to define the epidemiology of these infections.

Failure of cooking to prevent shellfish-associated viral gastroenteritis.

Background: In January 1995, Florida experienced the largest outbreak of oyster-associated gastroenteritis ever reported.

Methods: We interviewed both the cohort of persons from 38 gatherings where illness was reported and a sample of harvesters and harvest-area residents. Oysters were traced by means of tags and dealer records, and water quality measures in harvest areas were reviewed.

The epidemiology of Vibrio infections in Florida, 1981-1993.

The epidemiology of 690 Vibrio infections reported in Florida during 1981-1993 is described. Most infections resulted in one of three clinical syndromes: gastroenteritis (51%), wound infections (24%), or primary septicemia (17%). Case-fatality rates were 1% for gastroenteritis, 5% for wound infections, and 44% for primary septicemia.

Hantavirus pulmonary syndrome in Florida: association with the newly identified Black Creek Canal virus.

Hantavirus pulmonary syndrome (HPS) is a recently recognized viral zoonosis. The first recognized cases were caused by a newly described hantavirus. Sin Nombre virus (previously known as Muerto Canyon virus), isolated from Peromyscus maniculatus (deer mouse).

Evaluation of long-term community recovery from Hurricane Andrew: sources of assistance received by population sub-groups.

Two three-stage cluster surveys were conducted in South Dade County, Florida, 14 months apart, to assess recovery following Hurricane Andrew. Response rates were 75 per cent and 84 per cent. Sources of assistance used in recovery from Hurricane Andrew differed according to race, per capita income, ethnicity, and education.

Long-term effects of Hurricane Andrew: revisiting mental health indicators.

Two population-based surveys of South Dade County, Florida, were conducted after Hurricane Andrew to compare hurricane-related symptoms of mental distress and describe the impact of mental health outreach teams. Households were selected by three-stage cluster sampling and findings from the two surveys, 13 months apart, were compared. Response rates were 75 per cent and 84 per cent.

Use of a modified cluster sampling method to perform rapid needs assessment after Hurricane Andrew.

Study Objective: To rapidly obtain population-based estimates of needs in the early aftermath of Hurricane Andrew in South Florida.

Methods: We used a modified cluster-sampling method (the Expanded Programme on Immunization [EPI] method) for three surveys. We selected a systematic sample of 30 quarter-mile square clusters for each survey and, beginning from a random start, interviewed members of seven consecutive occupied households in each cluster.

Patient-to-patient transmission of hepatitis B in a dermatology practice.

Objective: The purpose of the study was to investigate infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) among patients in a dermatology practice.

Methods: Historical cohort, matched case-control, and cross-sectional survey methods were used.

Results: The age-specific incidence of reported HBV infection in the practice from 1985 through 1991 was more than 12 times the expected rate.

Outbreak of Legionnaire's disease linked to a decorative fountain by molecular epidemiology.

The incubation period of Legionnaires' disease in five patients was traced to attendance at conventions in a hotel in the Orlando, Florida, area between January 6 and February 2, 1992. The five case patients (mean age, 69 years) were older than 55 randomly chosen controls (mean age, 53 years) who had also attended one of the same conventions (p = 0.007).

Vibrio vulnificus from raw oysters. Leading cause of reported deaths from foodborne illness in Florida.

Seventy-two cases of Vibrio vulnificus infection from raw oysters were reported from 1981-1992; 36 (50%) patients died, making this infection the leading cause of reported deaths from foodborne illness in Florida. The bacterium naturally occurs in coastal waters and may contaminate legally harvested and properly handled shellfish. Infection, usually by ingestion of contaminated raw oysters, can cause severe illness especially in individuals with preexisting liver disease.