Toxoplasmosis Outbreak Associated With Toxoplasma gondii-Contaminated Venison-High Attack Rate, Unusual Clinical Presentation, and Atypical Genotype.

Background: During 2017, in response to a physician's report, the Wisconsin Department of Health Services, Division of Public Health, began investigating an outbreak of febrile illness among attendees of a retreat where never frozen, intentionally undercooked, locally harvested venison was served. Preliminary testing tentatively identified the illness as toxoplasmosis.

Methods: Confirmatory human serology panels and testing of the venison to confirm and categorize the presence and type of Toxoplasma gondii were completed by French and American national reference laboratories.

Outbreak of Seoul Virus Among Rats and Rat Owners - United States and Canada, 2017.

In December 2016, the Wisconsin Department of Health Services (WDHS) notified CDC of a patient hospitalized with fever, leukopenia, elevated transaminases, and proteinuria. The patient owned and operated an in-home rattery, or rat-breeding facility, with approximately 100 Norway rats, primarily bred as pets. A family member developed similar symptoms 4 weeks later, but was not hospitalized.

Babesiosis Surveillance - Wisconsin, 2001-2015.

Babesiosis is an emerging zoonotic disease caused primarily by Babesia microti, an intraerythocytic protozoan. Babesia microti, like the causal agents for Lyme disease and anaplasmosis, is endemic to the northeastern and upper midwestern United States where it is usually transmitted by the blacklegged tick, Ixodes scapularis. Although babesiosis is usually a mild to moderate illness, older or immunocompromised persons can develop a serious malaria-like illness that can be fatal without prompt treatment.

Transmission of Babesia microti Parasites by Solid Organ Transplantation.

Babesia microti, an intraerythrocytic parasite, is tickborne in nature. In contrast to transmission by blood transfusion, which has been well documented, transmission associated with solid organ transplantation has not been reported. We describe parasitologically confirmed cases of babesiosis diagnosed ≈8 weeks posttransplantation in 2 recipients of renal allografts from an organ donor who was multiply transfused on the day he died from traumatic injuries.

Outbreak of variant influenza A(H3N2) virus in the United States.

Background: Variant influenza virus infections are rare but may have pandemic potential if person-to-person transmission is efficient. We describe the epidemiology of a multistate outbreak of an influenza A(H3N2) variant virus (H3N2v) first identified in 2011.

Methods: We identified laboratory-confirmed cases of H3N2v and used a standard case report form to characterize illness and exposures.

An outbreak of Legionnaires disease associated with a decorative water wall fountain in a hospital.

Objective: To detect an outbreak-related source of Legionella, control the outbreak, and prevent additional Legionella infections from occurring.

Design And Setting: Epidemiologic investigation of an acute outbreak of hospital-associated Legionnaires disease among outpatients and visitors to a Wisconsin hospital.

Patients: Patients with laboratory-confirmed Legionnaires disease who resided in southeastern Wisconsin and had illness onsets during February and March 2010.

Seoul virus infection in a Wisconsin patient with recent travel to China, March 2009: first documented case in the Midwestern United States.

Diagnosis of Seoul virus-associated hemorrhagic fever with renal syndrome (HFRS) cases among United States residents is rare. We describe confirmation of a Seoul virus infection in a 36-year-old scientist who worked with laboratory rats in Milwaukee, Wisconsin, but most likely acquired the infection during a trip to Shenyang, China.

Human multidrug-resistant Salmonella Newport infections, Wisconsin, 2003-2005.

We conducted a retrospective study of Salmonella Newport infections among Wisconsin residents during 2003-2005. Multidrug resistance prevalence was substantially greater in Wisconsin than elsewhere in the United States. Persons with multidrug-resistant infections were more likely than persons with susceptible infections to report exposure to cattle, farms, and unpasteurized milk.

Occupational risks during a monkeypox outbreak, Wisconsin, 2003.

We determined factors associated with occupational transmission in Wisconsin during the 2003 outbreak of prairie dog--associated monkeypox virus infections. Our investigation included active contact surveillance, exposure-related interviews, and a veterinary facility cohort study. We identified 19 confirmed, 5 probable, and 3 suspected cases.

Epidemiologic features of human babesiosis in Wisconsin, 1996-2005.

Objective: To characterize epidemiologic, clinical, and laboratory features of babesiosis occurring in Wisconsin residents.

Design: Conduct a review of all cases of babesiosis reported to the Wisconsin Division of Public Health with onsets during 1996-2005. For case patients with onsets during 2004, pertinent medical records were reviewed and patient interviews were performed.

Monkeypox zoonotic associations: insights from laboratory evaluation of animals associated with the multi-state US outbreak.

At the onset of the 2003 US monkeypox outbreak, virologic data were unavailable regarding which animal species were involved with virus importation and/or subsequent transmission to humans and whether there was a risk for establishment of zoonotic monkeypox in North America. Similarly, it was unclear which specimens would be best for virus testing. Monkeypox DNA was detected in at least 33 animals, and virus was cultured from 22.

Meningococcal disease incidence and mortality in Wisconsin, 1993-2002.

Neisseria meningitidis is a major cause of sepsis and meningitis in children and young adults in the United States. To examine recent epidemiologic features of meningococcal disease in Wisconsin, we evaluated Wisconsin case surveillance data collected during 1993-2002. Surveillance data for cases with onsets during this time were analyzed; statistical trends were assessed.

The detection of monkeypox in humans in the Western Hemisphere.

Background: During May and June 2003, an outbreak of febrile illness with vesiculopustular eruptions occurred among persons in the midwestern United States who had had contact with ill pet prairie dogs obtained through a common distributor. Zoonotic transmission of a bacterial or viral pathogen was suspected.

Methods: We reviewed medical records, conducted interviews and examinations, and collected blood and tissue samples for analysis from 11 patients and one prairie dog.

Lyme disease incidence in Wisconsin: a comparison of state-reported rates and rates from a population-based cohort.

Few studies have assessed the accuracy and completeness of Lyme disease surveillance systems. Lyme disease cases were identified through review of medical records for residents of the Marshfield Epidemiologic Study Area (MESA), a population-based cohort of nearly 80,000 in north-central Wisconsin for which comprehensive medical care data are available through the Marshfield Clinic. These cases were compared with cases reported to the Wisconsin Division of Public Health to estimate the completeness of reporting.