Creating a Legion of Diabetes Patient Advocates: DPAC Policy Training Meeting and Hill Day.

The Diabetes Patient Advocacy Coalition (DPAC) held a Policy Training Meeting and Hill Day September 29-October 1, 2018, in Washington, DC. Attendees were members of DPAC's Board of Directors and Staff, Patient Advisory Board, and individuals identified through a competitive call for applicants on DPAC's website and social media. We were joined by advocates from the Association of Black Cardiologists and the Endocrine Society.

Legionnaires' Disease Outbreak at a Resort in Cozumel, Mexico.

 A Legionnaires' disease (LD) outbreak at a resort on Cozumel Island in Mexico was investigated by a joint Mexico-United States team in 2010. This is the first reported LD outbreak in Mexico, where LD is not a reportable disease.  Reports of LD among travelers were solicited from US health departments and the European Working Group for Infections.

Vital Signs: Deficiencies in Environmental Control Identified in Outbreaks of Legionnaires' Disease - North America, 2000-2014.

Background: The number of reported cases of Legionnaires' disease, a severe pneumonia caused by the bacterium Legionella, is increasing in the United States. During 2000-2014, the rate of reported legionellosis cases increased from 0.42 to 1.

Factors associated with tick bites and pathogen prevalence in ticks parasitizing humans in Georgia, USA.

Background: The incidence and emergence of tick-borne diseases has increased dramatically in the United States during the past 30 years, yet few large-scale epidemiological studies have been performed on individuals bitten by ticks. Epidemiological information, including disease development, may provide valuable information regarding effectiveness of tick bite prevention education, pathogen transmission, human-disease dynamics, and potential implications for under reporting of tick-borne diseases.

Methods: Ticks found attached to Georgia residents were submitted for identification and polymerase chain reaction (PCR) testing for Francisella tularensis, Ehrlichia, Anaplasma, Borrelia, and Rickettsia spp.

Legionnaires' Disease Outbreak at a Long-Term Care Facility Caused by a Cooling Tower Using an Automated Disinfection System--Ohio, 2013.

On July 9, 2013, an outbreak of Legionnaires' disease (LD) was identified at Long-Term Care Facility A in central Ohio. This article describes the investigation of the outbreak and identification of the outbreak source, a cooling tower using an automated biocide delivery system. In total, 39 outbreak LD cases were identified; among these, six patients died.

Active Bacterial Core Surveillance for Legionellosis - United States, 2011-2013.

During 2000–2011, passive surveillance for legionellosis in the United States demonstrated a 249% increase in crude incidence, although little was known about the clinical course and method of diagnosis. In 2011, a system of active, population-based surveillance for legionellosis was instituted through CDC’s Active Bacterial Core surveillance (ABCs) program. Overall disease rates were similar in both the passive and active systems, but more complete demographic information and additional clinical and laboratory data were only available from ABCs.

Outbreaks Associated With Environmental and Undetermined Water Exposures - United States, 2011-2012.

Exposures to contaminated water can lead to waterborne disease outbreaks associated with various sources, including many that are classified and reported separately as drinking water or recreational water. Waterborne disease outbreaks can also involve a variety of other exposures (e.g.

Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water - United States, 2011-2012.

Advances in water management and sanitation have substantially reduced waterborne disease in the United States, although outbreaks continue to occur. Public health agencies in the U.S.

The importance of clinical surveillance in detecting legionnaires' disease outbreaks: a large outbreak in a hospital with a Legionella disinfection system-Pennsylvania, 2011-2012.

Background: Healthcare-associated Legionnaires' disease (LD) is a preventable pneumonia with a 30% case fatality rate. The Centers for Disease Control and Prevention guidelines recommend a high index of suspicion for the diagnosis of healthcare-associated LD. We characterized an outbreak and evaluated contributing factors in a hospital using copper-silver ionization for prevention of Legionella growth in water.

On-site availability of Legionella testing in acute care hospitals, United States.

We surveyed 399 US acute care hospitals regarding availability of on-site Legionella testing; 300 (75.2%) did not offer Legionella testing on site. Availability varied according to hospital size and geographic location.

Diversity of piroplasms detected in blood-fed and questing ticks from several states in the United States.

Piroplasms in the genera Babesia, Theileria, and Cytauxzoon are tick-borne parasites that may be animal and human pathogens. Most piroplasms with known life cycles are transmitted by ixodid ticks; however, for many species, the vector is unknown. This study was conducted to determine the prevalence and diversity of piroplasms in ticks from several US states.

Surveillance for waterborne disease outbreaks and other health events associated with recreational water --- United States, 2007--2008.

Problem/condition: Since 1978, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaborated on the Waterborne Disease and Outbreak Surveillance System (WBDOSS) for collecting and reporting data on waterborne disease outbreaks associated with recreational water.

Rickettsia parkeri in Amblyomma americanum ticks, Tennessee and Georgia, USA.

To determine the geographic distribution of the newly recognized human pathogen Rickettsia parkeri, we looked for this organism in ticks from Tennessee and Georgia, USA. Using PCR and sequence analysis, we identified R. parkeri in 2 Amblyomma americanum ticks.

Geographic distribution and genetic diversity of the Ehrlichia sp. from Panola Mountain in Amblyomma americanum.

Background: A novel Ehrlichia, closely related to Ehrlichia ruminantium, was recently discovered from Panola Mountain State Park, GA, USA. We conducted a study to determine if this agent was recently introduced into the United States.

Methods: We developed a sensitive PCR assay based on the conserved gltA (citrate synthase) gene and tested DNA samples extracted from 1964 field-collected and 1835 human-biting Amblyomma americanum from 23 eastern states of the USA.

Hantavirus pulmonary syndrome--United States: updated recommendations for risk reduction. Centers for Disease Control and Prevention.

This report provides updated recommendations for prevention and control of hantavirus infections associated with rodents in the United States. It supersedes the previous report (CDC. Hantavirus infection--southwestern United States: interim recommendations for risk reduction.