Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak-Iowa, 2015-2016.

Background: The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015-2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine.

Mumps Outbreak in a Highly Vaccinated University-Affiliated Setting Before and After a Measles-Mumps-Rubella Vaccination Campaign-Iowa, July 2015-May 2016.

Background: In response to a mumps outbreak at the University of Iowa and surrounding community, university, state, and local health officials implemented a vaccination campaign targeting students <25 years of age with an additional dose of measles-mumps-rubella (MMR) vaccine. More than 4700 vaccine campaign doses were administered; 97% were documented third doses. We describe the epidemiology of the outbreak before and after the campaign, focusing on cases in university students.

Effectiveness of a Third Dose of MMR Vaccine for Mumps Outbreak Control.

Background: The effect of a third dose of the measles-mumps-rubella (MMR) vaccine in stemming a mumps outbreak is unknown. During an outbreak among vaccinated students at the University of Iowa, health officials implemented a widespread MMR vaccine campaign. We evaluated the effectiveness of a third dose for outbreak control and assessed for waning immunity.

High clinical suspicion of donor-derived disease leads to timely recognition and early intervention to treat solid organ transplant-transmitted lymphocytic choriomeningitis virus.

Despite careful donor screening, unexpected donor-derived infections continue to occur in organ transplant recipients (OTRs). Lymphocytic choriomeningitis virus (LCMV) is one such transplant-transmitted infection that in previous reports has resulted in a high mortality among the affected OTRs. We report a LCMV case cluster that occurred 3 weeks post-transplant in three OTRs who received allografts from a common organ donor in March 2013.

Notes from the field: infant botulism caused by Clostridium baratii type F - Iowa, 2013.

In June 2013, a male newborn aged 9 days (delivered after a full-term pregnancy) was brought to a hospital emergency department with a 2-day history of constipation, fussiness, and poor feeding. The mother reported her son's symptoms as excessive crying, reluctance to suck, and difficulty in swallowing milk. Within hours of arrival, the infant became less responsive and "floppy," and was intubated for respiratory failure.

Human infections with influenza A(H3N2) variant virus in the United States, 2011-2012.

BACKGROUND. During August 2011-April 2012, 13 human infections with influenza A(H3N2) variant (H3N2v) virus were identified in the United States; 8 occurred in the prior 2 years. This virus differs from previous variant influenza viruses in that it contains the matrix (M) gene from the Influenza A(H1N1)pdm09 pandemic influenza virus.

Results of rapid needs assessments in rural and urban Iowa following large-scale flooding events in 2008.

Background: On June 8 and 9, 2008, more than 4 inches of rain fell in the Iowa-Cedars River Basin causing widespread flooding along the Cedar River in Benton, Linn, Johnson, and Cedar Counties. As a result of the flooding, there were 18 deaths, 106 injuries, and over 38,000 people displaced from their homes; this made it necessary for the Iowa Department of Health to conduct a rapid needs assessment to quantify the scope and effect of the floods on human health.

Methods: In response, the Iowa Department of Public Health mobilized interview teams to conduct rapid needs assessments using Geographic Information Systems (GIS)-based cluster sampling techniques.

Voluntary reporting of employee influenza vaccination rates by acute care hospitals in Iowa: the impact of a four year provider-based statewide performance improvement project.

Objective: In 2006 a voluntary, provider-based project was initiated to improve influenza vaccination rates among healthcare workers (HCWs) employed by acute care hospitals in Iowa. The statewide vaccination target was 95% by 2010. Data from the first four influenza seasons (2006-2007, 2007-2008, 2008-2009 and 2009-2010) are presented.

Triple-reassortant swine influenza A (H1) in humans in the United States, 2005-2009.

Background: Triple-reassortant swine influenza A (H1) viruses--containing genes from avian, human, and swine influenza viruses--emerged and became enzootic among pig herds in North America during the late 1990s.

Methods: We report the clinical features of the first 11 sporadic cases of infection of humans with triple-reassortant swine influenza A (H1) viruses reported to the Centers for Disease Control and Prevention, occurring from December 2005 through February 2009, until just before the current epidemic of swine-origin influenza A (H1N1) among humans. These data were obtained from routine national influenza surveillance reports and from joint case investigations by public and animal health agencies.

Mumps vaccination coverage and vaccine effectiveness in a large outbreak among college students--Iowa, 2006.

Following implementation of a routine childhood two-dose measles-mumps-rubella vaccination strategy, mumps disease levels dropped dramatically in the US and an elimination goal was set for 2010. However, a 2006 epidemic involved >5700 cases nationwide, with many reported among fully vaccinated college students. In an outbreak in two Iowa colleges, we investigated: (1) vaccination coverage using electronic records verified by provider records and (2) vaccine effectiveness assessed by comparison of dose-specific attack rates.

Pertussis outbreak in an elementary school with high vaccination coverage.

Background: An outbreak of pertussis in a US elementary school with high vaccination coverage was investigated to evaluate vaccine effectiveness and to identify potential contributing factors.

Methods: Survey and cohort study of all 215 students of an elementary school (including 36 case patients) and 16 secondary cases among contacts.

Results: Fifty-two pertussis cases were identified (attack rate among students, 17%).

Severe pneumococcal pneumonia in previously healthy children: the role of preceding influenza infection.

An outbreak of severe pneumococcal pneumonia among children occurred in Iowa from November 1995 through January 1996. An associated outbreak of influenza disease was predominantly caused by influenza A (H1N1) for the first time since 1989. We conducted a case-control study to determine whether preceding influenza infection was directly associated with pneumococcal illness.

Morphologic and staining characteristics of a cyanobacterium-like organism associated with diarrhea.

A spherical organism 9-10 microns in diameter, seen in three outbreaks of diarrhea in Southeast Asia and the United States during the past 2 years, bore characteristics of a cyanobacterium when observed in formalin-preserved stool specimens and by electron microscopy. Organisms in freshly passed stool specimens showed an internal morula of lipid-containing globules. In fresh water, the morula divided into two sausage-shaped structures resembling the sporocysts of an isosporid coccidian.