In this investigation, exposure to duodenoscopes with bacterial contamination was associated with apparent transmission of NDM-producing E coli among patients at 1 hospital. Bacterial contamination of duodenoscopes appeared to persist despite the absence of recognized reprocessing lapses. Facilities should be aware of the potential for transmission of bacteria including antimicrobial-resistant organisms via this route and should conduct regular reviews of their duodenoscope reprocessing procedures to ensure optimal manual cleaning and disinfection.

BACKGROUND School closure is one of the primary measures considered during severe influenza pandemics and other emergencies. However, prolonged school closures may cause unintended adverse consequences to schools, students, and their families. A better understanding of these consequences will inform prepandemic planning, and help public health and education authorities in making informed decisions when considering school closures. METHODS We conducted a household survey and interviewed school officials following an 8‐day long closure of a school district in rural Illinois. We described household responses regarding difficulties of school closure, and summarized main themes from school official interviews. RESULTS A total of 208 (27%) household surveys were completed and returned. This school closure caused difficulties to 36 (17%) households; uncertain duration of closure, childcare arrangements, and lost pay were the most often reported difficulties. Having 1 adult in the household losing pay and household income below $25,000 were significantly associated with overall difficulty during this school closure. Concern about student health and safety was the most frequent theme in school administrator interviews. CONCLUSIONS Whereas the majority of responding households did not report difficulties during this school closure, households with 1 adult losing pay during the closure reported incurring additional expenses for childcare.

Laminar cirrus are thin, extensive, isolated layers of ice clouds frequently observed in the tropical tropopause layer. Widespread laminar cirrus significantly affects tropical tropopause layer total water and thermal budget. In this study, we extract laminar cirrus from the Cloud‐Aerosol Lidar with Orthogonal Polarization Level 1 attenuated total backscatter images for January 2009, in order to characterize statistical properties of laminar cirrus cloud length, base, thickness, optical depth, and layer partial ice water path. These characteristics are used to develop an algorithm identifying laminar cirrus automatically from the Cloud‐Aerosol Lidar with Orthogonal Polarization Level 2 layer product for 2008–2017. The nearly 10‐year records reveal that tropopause laminar cirrus occurrence (30–40% of total cirrus) is strongly anticorrelated with the tropopause temperatures in that colder tropopause in frequent (super)saturation during boreal winter favors in situ formation of clouds. Interannually, anomalously warmer troposphere temperature (ΔT), easterly shear of the quasi‐biennial oscillation, and stronger upwelling branch of the Brewer‐Dobson circulation enhance laminar cirrus formation via cooling of the tropopause. The tropopause laminar cirrus carries ~0.05 mg/m3 (~0.5 ppmv) of ice water content during boreal winter and <0.01 mg/m3 during summer, which is anticorrelated with the seasonal variations of water vapor (H2O) observed by the Microwave Lime Sounder, indicating a temperature‐regulated partition between vapor and ice. Interannually, in cirrus‐rich region 1 ppmv decrease in H2O corresponds to 0.2–0.3 ppmv increase in ice water content. Frequently situated in (super)saturated air, tropopause laminar cirrus are likely to survive multiple lifecycles of the sublimation‐deposition processes, and may contribute up to 10% to the total water budget in the lower stratosphere.