Outbreak
When people move into or change an environment, microbes that cause illness can "jump" from wildlife to humans and cause disease outbreaks that can spread internationally. Tracking down and responding to these outbreaks requires coordinated detective work from people in many professions.
Outbreak
Date Posted: Date the investigation is posted to the table. This happens once CORE begins to actively coordinate an investigation. In collaboration with federal and state partners, CORE initiates response activities to control the outbreak or adverse events.
Total Case Count: Updated weekly. For outbreak investigations, the case count is provided to the FDA by the CDC. Case counts are dynamic and the exact number of illnesses constantly changes during an investigation. This number is provided in order to provide an estimate of the size of an outbreak each week. In the case of adverse event investigations, FDA will provide the number of adverse events that have been self-reported by consumers to FDA consumer complaint coordinators and the CFSAN Adverse Event Reporting System (CAERS), which could include duplicate reports. More formalized data will be published in CDC Investigation Notices or in FDA and CDC advisories, should they be posted.
The FDA, along with CDC and state and local partners, investigated a multistate outbreak of Salmonella Senftenberg infections linked to certain Jif brand peanut butter products produced at the J.M. Smucker Company facility in Lexington, Kentucky.
The FDA, along with CDC and state and local partners, are investigating a multistate outbreak of Salmonella Senftenberg infections linked to certain Jif brand peanut butter products produced at the J.M. Smucker Company facility in Lexington, Kentucky.
During surges, state and local public health agencies may focus outbreak investigation resources on six populations identified as being at greatest risk of adverse outcomes or significant disruptions due to COVID-19. At-risk populations include healthcare, correctional settings, highly mobile populations, schools, critical infrastructure, and tribes and Native communities.
SummaryThe Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory about infections with an extensively drug-resistant strain of Verona Integron-mediated Metallo-β-lactamase (VIM) and Guiana-Extended Spectrum-β-Lactamase (GES)-producing carbapenem-resistant Pseudomonas aeruginosa (VIM-GES-CRPA) in 12 states. Most patients reported using artificial tears. Patients reported more than 10 different brands of artificial tears, and some patients used multiple brands. The majority of patients who used artificial tears reported using EzriCare Artificial Tears, a preservative-free, over-the-counter product packaged in multidose bottles. CDC laboratory testing identified the presence of the outbreak strain in opened EzriCare bottles with different lot numbers collected from two states. Patients and healthcare providers should immediately discontinue using EzriCare artificial tears pending additional guidance from CDC and the Food and Drug Administration (FDA).
Isolates in this outbreak are sequence type (ST) 1203, harbor blaVIM-80 and blaGES-9 (a combination not previously observed in the United States) and are closely related based on analysis of whole genome sequencing (WGS) data. These isolates are not susceptible to cefepime, ceftazidime, piperacillin-tazobactam, aztreonam, carbapenems, ceftazidime-avibactam, ceftolozane-tazobactam, fluoroquinolones, polymyxins, amikacin, gentamicin, and tobramycin; the subset of isolates that underwent antimicrobial susceptibility testing for cefiderocol were susceptible to this agent.
Review of common exposures revealed that most patients, including most patients with eye infections, used artificial tears prior to identification of VIM-GES-CRPA infection or colonization. Patients reported more than 10 brands of artificial tears, and some patients used multiple brands. The majority of patients who used artificial tears reported using EzriCare Artificial Tears, a preservative-free product dispensed in multidose bottles. This was the only common artificial tears product identified across the four healthcare facility clusters. CDC laboratory testing identified the presence of VIM-GES-CRPA in opened EzriCare Artificial Tears bottles from multiple lots; these bottles were collected from patients with and without eye infections in two states. These product-related VIM-GES-CRPA match the outbreak strain. VIM-GES-CRPA recovered from opened bottles could represent either bacterial contamination during use or during the manufacturing process. Testing of unopened bottles of EzriCare Artificial Tears is ongoing to assist in evaluating for whether contamination may have occurred during manufacturing.
The outbreak began Jan. 3, when laboratory testing confirmed measles in a child who traveled to Clark County from Ukraine. Based on the information gathered during the investigation, Public Health could not determine whether this case was the source of the outbreak.
During the outbreak investigation, Public Health identified and contacted more than 4,100 people who were exposed to measles and made daily monitoring phone calls to more than 800 people considered susceptible to contracting measles. Local schools identified and excluded 849 susceptible students who were exposed to measles.
Public Health activated its incident management teams to respond to the measles outbreak on Jan. 15 and spent 63 days in incident response. More than 230 people worked on the incident, including 89 Public Health staff, 57 Washington Department of Health staff, 50 Medical Reserve Corps volunteers and three Centers for Disease Control and Prevention staff, as well as partners from other health departments and local volunteers.
During the outbreak, Public Health identified suspect cases who were unimmunized when exposed to measles and received the measles-mumps-rubella (MMR) vaccine more than 72 hours after exposure. To prevent illness, one dose of MMR vaccine must be given to unimmunized people within 72 hours of exposure.
Clark County Council Chair Eileen Quiring declared on Friday, Jan. 18 a public health emergency in response to the measles outbreak. On Friday, Jan. 25, Gov. Jay Inslee declared a state of emergency in response to the measles outbreak in Washington.
During the measles outbreak, Public Health relied on the WAIIS data to determine immunization rates among Clark County youth. Public Health and the state Department of Health consider WAIIS data to be the best source to calculate childhood immunization rates.
The numbers and percentages in the WAIIS dataset have been confirmed during our outbreak investigation. When we responded to affected schools, the documentation that parents were able (or not able) to produce confirmed that the WAIIS data were accurate.
For years, the United States has invested in research on monkeypox and in tools to effectively respond to the disease. Monkeypox is a virus that is generally spread through close or intimate contact, with symptoms that include a rash and fever. It is much less transmissible than fast-spreading respiratory diseases like COVID-19, and this outbreak has not caused any deaths in the United States. The virus, however, is spreading in the United States and globally, and requires a comprehensive response from federal, state, local, and international governments and communities. Since the first United States case was confirmed on May 18, President Biden has taken critical actions to make vaccines, testing, and treatments available to those who need them as part of its whole-of-government monkeypox outbreak response.
Today, the Biden-Harris Administration announced the first phase of its national monkeypox vaccine strategy, a critical part of its monkeypox outbreak response. The vaccine strategy will help immediately address the spread of the virus by providing vaccines across the country to individuals at high risk. This phase of the strategy aims to rapidly deploy vaccines in the most affected communities and mitigate the spread of the disease.
As part of the monkeypox outbreak response, the Biden-Harris Administration is launching a national strategy to provide vaccines for monkeypox for individuals at higher risk of exposure. The strategy aims to mitigate the spread of the virus in communities where transmission has been the highest and with populations most at risk. This plan distributes the two-dose JYNNEOS vaccine, which the Food and Drug Administration (FDA) approved for protection against smallpox and monkeypox in individuals 18 years and older determined to be at high risk for smallpox or monkeypox infection. States will be offered an equitable allotment based on cases and proportion of the population at risk for severe disease from monkeypox, and the federal government will partner with state, local, and territorial governments in deploying the vaccines.
This expansion reflects the latest, most significant increase in testing accessibility, building on the capacities already available within the Laboratory Response Network (LRN). CDC has worked with the LRN to increase public health testing capacity by more than 50% since the start of the outbreak, increasing testing capacity from 6,000 tests per week to approximately 10,000 test per week. This network continues to provide spare testing capacity to jurisdictions across the country. CDC is working with state, territorial, and local health departments to make the monkeypox testing process more accessible to health care providers.
Since the start of the monkeypox outbreak, the number of days from average symptom onset to test has decreased by approximately 35%, enabling patients to more quickly learn their diagnosis, access care, and prevent spread to others. The expansion of testing aims to facilitate further reductions in the gap between symptom onset and test result, maximizing access to treatment and vaccines for patients and high-risk contacts early in the course of disease. 041b061a72