Publications by authors named "Kimberly Signs"

Orthohantaviruses cause hantavirus cardiopulmonary syndrome; most cases occur in the southwest region of the United States. We discuss a clinical case of orthohantavirus infection in a 65-year-old woman in Michigan and the phylogeographic link of partial viral fragments from the patient and rodents captured near the presumed site of infection.

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  • A unique enzootic focus of Mycobacterium bovis in free-ranging deer was identified in Michigan, leading to human cases linked to these deer between 1994 and 2022; four new cases were confirmed using genomic epidemiology.
  • Genetic analysis showed a close connection between human and animal strains, with some cases having minimal genetic differences from deer and cattle isolates.
  • Ongoing transmission of M. bovis from deer to humans and cattle poses a public health risk, prompting the need for future studies and a One Health approach to tackle TB transmission effectively.
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  • * An investigation revealed a cluster of COVID-19 symptoms among farm employees coinciding with increased illness and death rates in mink, with nearly all sampled mink testing positive for the virus.
  • * Genetic similarities between the virus in mink and infected workers suggest that humans contracted COVID-19 from the mink, prompting the need for comprehensive public health strategies to control zoonotic virus transmission.
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Histoplasmosis is one of the most under-diagnosed and under-reported endemic mycoses in the United States. is the causative agent of this disease. To date, molecular epidemiologic studies detailing the phylogeographic structure of in the United States have been limited.

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Background: To characterize neurodevelopmental abnormalities in children up to 36 months of age with congenital Zika virus exposure.

Methods: From the U.S.

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On June 16, 2021, rabies virus infection was confirmed in a dog included in a shipment of rescue animals imported into the United States from Azerbaijan. A multistate investigation was conducted to prevent secondary rabies cases, avoid reintroduction of a dog-maintained rabies virus variant (DMRVV), identify persons who might have been exposed and would be recommended to receive rabies postexposure prophylaxis, and investigate the cause of importation control failures. Results of a prospective serologic monitoring (PSM) protocol suggested that seven of 32 (22%) animals from the same shipment as the dog with confirmed rabies virus infection and who had available titer results after rabies vaccine booster had not been adequately vaccinated against rabies before importation.

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  • Lyme disease and other tick-borne diseases are significant public health concerns in the Upper Midwest, particularly in Michigan, Minnesota, and Wisconsin, prompting officials to recommend various prevention measures.
  • A survey conducted in 2019 across 48 high-risk counties revealed that while 98% of people had heard of Lyme disease and many recognized its seriousness, only about 25% thought tick-borne diseases were common in their community.
  • Despite this, there seems to be a high willingness among the population to adopt preventive behaviors, with 82% willing to perform daily tick checks and over 60% open to using bug repellent and tick control products for pets.*
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  • * Among 6,799 live-born infants studied from December 2015 to March 2018, 4.6% had Zika-related birth defects, with a higher rate of 6.1% in those with confirmed infection.
  • * Common defects included microcephaly and other brain abnormalities, with many infants showing multiple defects, highlighting the need for targeted surveillance during potential Zika outbreaks.
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Eastern equine encephalomyelitis (EEE) is a mosquito-borne viral disease that is an emerging public health concern in the state of Michigan. Although Michigan has one of the highest incidence rates of EEE in the United States, much of the information known about cases in humans, equines, and other animals residing in Michigan is unpublished. This article summarizes such information and explores spatial trends in the historic distribution of EEE in Michigan.

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Blastomycosis is caused by inhalation of spp. fungi. Limited data are available on the incidence and geographic range of blastomycosis in the United States.

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Background: Histoplasmosis is often described as the most common endemic mycosis in the United States, but much remains unknown about its epidemiology among the general population.

Methods: We conducted enhanced surveillance in 9 states during 2018-2019 by identifying cases through routine surveillance and interviewing 301 patients about their clinical features and exposures.

Results: Before being tested for histoplasmosis, 60% saw a health care provider ≥3 times, and 53% received antibacterial medication.

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Centers for Disease Control and Prevention (CDC), health departments, and other state and federal partners have linked contact with live poultry to 70 human Salmonella outbreaks in the United States from 2000 to 2017, which resulted in a total of 4,794 illnesses, 894 hospitalizations, and 7 deaths. During human salmonellosis outbreaks environmental sampling is rarely conducted as part of the outbreak investigation. CDC was contacted by state health officials on June 12, 2018, to provide support during an investigation of risk factors for Salmonella infections linked to live poultry originating at a mail-order hatchery.

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Background: Rapid reporting of human infections with novel influenza A viruses accelerates detection of viruses with pandemic potential and implementation of an effective public health response. After detection of human infections with influenza A (H3N2) variant (H3N2v) viruses associated with agricultural fairs during August 2016, the Michigan Department of Health and Human Services worked with the US Centers for Disease Control and Prevention (CDC) to identify infections with variant influenza viruses using a text-based illness monitoring system.

Objective: To enhance detection of influenza infections using text-based monitoring and evaluate the feasibility and acceptability of the system for use in future outbreaks of novel influenza viruses.

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Histoplasmosis is one of the most common mycoses endemic to the United States, but it was reportable in only 10 states during 2016, when a national case definition was approved. To better characterize the epidemiologic features of histoplasmosis, we analyzed deidentified surveillance data for 2011-2014 from the following 12 states: Alabama, Arkansas, Delaware, Illinois, Indiana, Kentucky, Michigan, Minnesota, Mississippi, Nebraska, Pennsylvania, and Wisconsin. We examined epidemiologic and laboratory features and calculated state-specific annual and county-specific mean annual incidence rates.

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On August 3, 2016, the Ohio Department of Health Laboratory reported to CDC that a respiratory specimen collected on July 28 from a male aged 13 years who attended an agricultural fair in Ohio during July 22-29, 2016, and subsequently developed a respiratory illness, tested positive by real-time reverse transcription-polymerase chain reaction (rRT-PCR) for influenza A(H3N2) variant* (H3N2v). The respiratory specimen was collected as part of routine influenza surveillance activities. The next day, CDC was notified of a child aged 9 years who was a swine exhibitor at an agricultural fair in Michigan who became ill on July 29, 2016, and tested positive for H3N2v virus at the Michigan Department of Health and Human Services Laboratory.

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Context: Rabies virus causes a fatal encephalitis and is typically acquired through the bite of an infected mammal. Rabies is preventable through administration of rabies postexposure prophylaxis (PEP), but this must be balanced with the need to avoid unnecessary PEP use. Though not nationally notifiable, some state health departments (SHDs) have made animal bites and use of PEP reportable within their jurisdictions.

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Clonal VGII subtypes (outbreak strains) of Cryptococcus gattii have caused an outbreak in the US Pacific Northwest since 2004. Outbreak-associated infections occur equally in male and female patients (median age 56 years) and usually cause pulmonary disease in persons with underlying medical conditions. Since 2009, a total of 25 C.

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Q fever is a zoonosis caused by Coxiella burnetii, a unique bacterium that is widespread but infrequently associated with human illness or outbreaks. We report on evidence of infection with C. burnetii in a small group of regular consumers of raw (unpasteurized) milk from the same dairy in Michigan.

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We summarize the first reported case of acquired lymphocytic choriomeningitis virus (LCMV) infection in Michigan to be investigated by public health authorities and provide evidence of the focal nature of LCMV infection in domestic rodents. Results of serologic and virologic testing in rodents contrasted, and negative serologic test results should be confirmed by tissue testing.

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The Michigan Department of Community Health (MDCH) reported 644 laboratory positive human cases of West Nile Virus (WNV) in the 2002 outbreak in the US, of which 559 cases presented with either meningitis or encephalitis. The first line test utilized for diagnosis of WNV infection was the immunoglobulin M (IgM)-capture enzyme-linked immunosorbent assay (MAC-ELISA). We continued testing for WNV even during winter months of the year 2002-2003 due to the awareness of other modes of WNV transmission (blood transfusion, organ transplantation, transplacental, breast milk, and occupational) as well as concern for people traveling to endemic areas.

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Background: During the 2002 West Nile virus epidemic in the United States, patients were identified whose West Nile virus illness was temporally associated with the receipt of transfused blood and blood components.

Methods: Patients with laboratory evidence of recent West Nile virus infection within four weeks after receipt of a blood component from a donor with viremia were considered to have a confirmed transfusion-related infection. We interviewed the donors of these components, asking them whether they had had symptoms compatible with the presence of a viral illness before or after their donation; blood specimens retained from the time of donation and collected at follow-up were tested for West Nile virus.

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