Emergency Survey Methods in Acute Cryptosporidiosis Outbreak

Fox, LeAnne M.; Ocfemia, M. Cheryl Bañez; Hunt, D. Charles; Blackburn, Brian G.; Neises, Daniel; Kent, W. Kay; Beach, Michael J.; Pezzino, Gianfranco

doi:10.3201/eid1105.040871

Cited by 13 publications

(8 citation statements)

References 12 publications

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“…This outbreak illustrates the potential for enteric pathogens with low infectious doses to spread through person-to-person transmission following the introduction of the pathogen into a community through a point-source or common-source outbreak involving water, food or other appropriate source. Outbreaks involving multiple modes of transmission have been reported for Shigella [12] and Cryptosporidium [13]. This investigation demonstrates a similar capacity for Giardia ; the potential for such multi-mode spread may also exist for pathogens such as norovirus and hepatitis A virus.…”

Section: Discussionmentioning

confidence: 51%

Prolonged outbreak of giardiasis with two modes of transmission

et al. 2006

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Large outbreaks of giardiasis caused by person-to-person transmission, or a combination of transmission routes, have not previously been reported. A large, prolonged giardiasis outbreak affected families belonging to a country club in a suburb of Boston, Massachusetts, during June-December 2003. We conducted a retrospective cohort study to determine the source of this outbreak. Giardiasis-compatible illness was experienced by 149 (25%) respondents to a questionnaire, and was laboratory confirmed in 97 (65%) of these cases. Of the 30 primary cases, exposure to the children's pool at the country club was significantly associated with illness (risk ratio 3.3, 95% confidence interval 1.7-6.5). In addition, 105 secondary cases probably resulted from person-to-person spread; 14 cases did not report an onset date. This outbreak illustrates the potential for Giardia to spread through multiple modes of transmission, with a common-source outbreak caused by exposure to a contaminated water source resulting in subsequent prolonged propagation through person-to-person transmission in the community. This capacity for a common-source outbreak to continue propagation through secondary person-to-person spread has been reported with Shigella and Cryptosporidium and may also be a feature of other enteric pathogens having low infectious doses.

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Section: Discussionmentioning

confidence: 51%

Prolonged outbreak of giardiasis with two modes of transmission

et al. 2006

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“…Fox et al. used CATI techniques in an outbreak of cryptosporidiosis and concluded that the CATI method may be maximally applicable in large‐scale investigations 36 . The CATI has the added benefits of increasing a researcher's ability to approach more subjects when compared with face‐to‐face interviews.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of restless legs syndrome in Taiwanese adults

Chen¹,

Chuang

Yang³

et al. 2010

Psychiatry Clin Neurosci

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Aim: Few studies have examined the prevalence of restless legs syndrome (RLS) in Asian populations, with existing data suggesting substantially lower rates of RLS in Asian populations compared with Caucasians. However, varying definitions of RLS as well as problematic methodology make conclusions about RLS prevalence in Asian populations difficult to interpret. The current study therefore examines the prevalence of RLS in Taiwanese adults.Methods: Subjects were 4011 Taiwanese residents over the age of 15 years. Data was collected using a computer-assisted telephone interviewing (CATI) system between 25 October 2006 and 6 November 2006. Results:The prevalence of RLS in Taiwanese adults was found to be 1.57%. In addition, individuals with RLS had a higher body mass index (BMI) and incidence of chronic conditions and comorbidities including insomnia, hypertension, cardiovascular disease, respiratory disease, arthritis, backache and mental illness. Women with RLS also had a higher incidence of post-menopausal syndrome. Conclusion:Findings from the current study suggest that the prevalence of RLS in Taiwan is 1.57% by telephone interview. Individuals with RLS had a higher incidence of chronic insomnia and many other chronic disorders. The association and longterm consequences of RLS with these chronic disorders warrants further longitudinal observation and study.Key words: Asian, prevalence, restless legs syndrome, Taiwan, urge to move. R ESTLESS LEGS SYNDROME (RLS) is a common sensorimotor disorder first described by Willis in 1672.1 It is characterized by an urge to move, associated with paresthesias, worsening in the evening and relieved by activity. Ekbom, a Swedish neurologist, estimated that RLS affects 5% of the general population.2 The widely accepted diagnostic criteria for RLS was developed in 2003,3 in which the RLS Working Group revised the diagnosed criteria established by the International Restless Legs Syndrome Study Group (IRLSSG) in 1995. 4 The prevalence of RLS in Western countries is estimated to be 8.5-14.2% of the general population. 5-14Some studies have suggested that RLS prevalence doubles in women and with increasing age. [7][8][9] However, reports of RLS prevalence in Asian *Correspondence: Ning-Hung Chen, MD, Sleep Center, Chang Gung Memorial Hospital, 123, 333, TaoYang, Taipei, Taiwan. Email: ninghung@yahoo.com.tw, nhchen@adm.cgmh.org [15][16][17][18][19][20][21] Furthermore, the majority of these studies have problematic methodology and inconsistent definitions of RLS, which preclude a prevalence consensus. In order to understand the prevalence of RLS in the Asian population, a crucial study was designed according to the current definition of RLS with a valid methodology and that study served as the impetus for the current study. 4 METHODS SubjectsThe subjects were residents over the age of 15 years currently residing in Taiwan. The number of subjects to be interviewed was calculated according to the estimated prevalence in previous reports and the population distributions in each coun...

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“…Specifi cally, the E. coli O157 literature indicates that a large proportion (72%) of infections are asymptomatic (3), exposure to low doses can result in infection (4), and reported secondary transmission rates are on the order of 4%-16% (5). Further, outbreaks of shigellosis (6), cryptosporidiosis (7), and giardiasis (8,9) indicate that other highly infectious enteric pathogens can spread from person to person after being introduced into a community through water, food, or other sources (9). Recent adenovirus outbreak data indicate that persons with asymptomatic infection who are shedding virus can be a primary cause of continual transmission of infection (10).…”

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confidence: 99%

Strategies to Reduce Person-to-Person Transmission during WidespreadEscherichia coliO157:H7 Outbreak

Seto

Soller²,

Colford

2007

Emerg. Infect. Dis.

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RESEARCHDuring the Escherichia coli O157:H7 outbreak in 2006 in the United States, the primary strategy to prevent illness was to advise consumers not to eat spinach. No widespread warnings were issued about preventing person-to-person (secondary) transmission. A disease transmission model, fi tted to the current data, was used to investigate likely reductions in illnesses that could result from interventions to prevent secondary transmission. The model indicates that exposure to contaminated spinach occurred early in the outbreak and that secondary transmission was similar to that in previous E. coli outbreaks (≈12%). The model also suggests that even a modestly effective strategy to interrupt secondary transmission (prevention of only 2%-3% of secondary illnesses) could result in a reduction of ≈5%-11% of symptomatic cases. This analysis supports the use of widespread public health messages during outbreaks of E. coli O157:H7 with specifi c advice on how to interrupt secondary transmission.W idespread distribution of contaminated spinach was implicated in an Escherichia coli O157:H7 (E. coli O157) outbreak in the United States in 2006. As of September 24, 2006, a total of 173 cases had been reported in 25 states; 88% of cases were reported over an 18-day period from August 19 through September 5, 2006 (1). The outbreak strain was particularly virulent, resulting in 1 death, 53% of patients being hospitalized, and a 16% rate of hemolytic uremic syndrome. At the time of our analysis, the potential extent of the outbreak was unknown because new cases were still being reported. The Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration advised consumers not to eat spinach as the primary strategy for protecting against foodborne transmission of E. coli O157 (2). No warnings, however, were issued regarding the prevention of person-to-person (secondary) transmission.According to recent studies on the extent of secondary transmission for E. coli O157 and other pathogens, the initially reported foodborne illnesses in the outbreak may have represented only a small fraction of a larger outbreak that included asymptomatic infections and secondary infections among household members of infected persons and other close contacts. Specifi cally, the E. coli O157 literature indicates that a large proportion (72%) of infections are asymptomatic (3), exposure to low doses can result in infection (4), and reported secondary transmission rates are on the order of 4%-16% (5). Further, outbreaks of shigellosis (6), cryptosporidiosis (7), and giardiasis (8,9) indicate that other highly infectious enteric pathogens can spread from person to person after being introduced into a community through water, food, or other sources (9). Recent adenovirus outbreak data indicate that persons with asymptomatic infection who are shedding virus can be a primary cause of continual transmission of infection (10). And in a prolonged giardiasis outbreak that occurred in late 2003 in a Boston, Massachusetts, suburb, 30 ...

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Emergency Survey Methods in Acute Cryptosporidiosis Outbreak

Cited by 13 publications

References 12 publications

Prolonged outbreak of giardiasis with two modes of transmission

Prolonged outbreak of giardiasis with two modes of transmission

The prevalence of restless legs syndrome in Taiwanese adults

Strategies to Reduce Person-to-Person Transmission during WidespreadEscherichia coliO157:H7 Outbreak

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