Biomedical subjects

Carlota Medus

Publications and source records attributed to Carlota Medus.

7 recordsLinked to original sources

PubMed2006

Factors associated with seeking medical care and submitting a stool sample in estimating the burden of foodborne illness.

Laboratory-based surveillance is a foundation for public health and is essential for determining the incidence of most foodborne diseases caused by bacterial pathogens; however, reported cases represent a subset of infections in the community. To identify the factors associated with seeking medical care and submitting a stool specimen among persons with acute diarrheal illness, we used multivariate logistic regression to analyze data from two 12- month population-based telephone surveys conducted in the Foodborne Diseases Active Surveillance Network (FoodNet) from 2000 to 2003. Of 31,082 persons interviewed, 5% reported an acute diarrheal illness in the four weeks prior to the interview; of these, 20% sought medical care. On multivariate analysis, among persons with an acute diarrheal illness, factors associated with seeking medical care included: male sex; age <5 or >or=65 years; household income <25,000 dollars; having health insurance; diarrhea duration >or=3 days; having bloody diarrhea, fever, vomiting, sore throat, or cough. Of those seeking medical care, 19% provided a stool sample. Bloody diarrhea (odds ratio [OR] 3.35; 95% confidence interval [CI] 1.18-9.51) and diarrhea duration >or=3 days (OR 3.81; 95% CI: 1.50-9.69) were the most important factors associated with submission of a stool specimen. Cases of acute diarrheal illness ascertained through laboratory-based public health surveillance are likely to differ systematically from unreported cases and likely over-represent those with bloody diarrhea and longer diarrhea duration.

Acute Disease↗

PubMed2006

Salmonella outbreaks in restaurants in Minnesota, 1995 through 2003: evaluation of the role of infected foodworkers.

The 23 restaurant-associated salmonellosis outbreaks that occurred in Minnesota from 1995 through 2003 were reviewed to characterize the role of infected foodworkers. The median duration of the outbreaks was 21 days (range, 1 to 517 days). The median number of culture-confirmed patron cases per outbreak was seven (range, 1 to 36 cases). The median incubation for patron cases ranged from 9 h to 5.9 days. A specific food vehicle was implicated in four outbreaks and suspected in five. Salmonella of the same serotype and pulsed-field gel electrophoresis subtype as that found in patrons was recovered from foodworkers in 19 outbreaks. Overall, 12% (129 of 1,033) of foodworkers tested positive for Salmonella. Sixty-four (53%) of 121 Salmonella-positive foodworkers reported not having had a recent gastrointestinal illness. Overall, the median duration of Salmonella shedding was 16 days. Among foodworkers who reported gastrointestinal illness, the median shedding duration was 30 days as compared with 3 days for asymptomatic foodworkers. Positive environmental samples were recovered in 4 (33%) of 12 outbreaks. No specific food vehicle was identified in any outbreaks associated with Salmonella-positive environmental samples. The median duration of outbreaks with positive environmental samples (187 days) was significantly longer than the median duration of outbreaks with negative environmental results (26 days, P = 0.03). A higher proportion of Salmonella-positive foodworkers (22 versus 8%) was identified in outbreaks with positive environmental samples. Salmonella outbreaks in restaurants are frequently prolonged yet produce a small number of confirmed patron cases. Prolonged outbreak durations suggest a persistent reservoir of contamination. Infected foodworkers likely serve as an important source for Salmonella transmission. Therefore, assessment of foodworker infection is essential for controlling restaurant outbreaks.

Consumer Product Safety↗

PubMed2005

Food service workers' self-reported food preparation practices: an EHS-Net study.

This study was conducted by the Environmental Health Specialists Network (EHS-Net), a network of environmental health specialists and epidemiologists at federal and state health agencies, whose mission is to improve environmental health practice. One of EHS-Net's primary goals is to improve the understanding of the underlying causes of foodborne illness using a system-based approach. As part of this ongoing effort, EHS-Net analyzed data from a telephone survey of food service workers designed to increase our understanding of food preparation practices (a cause of foodborne illness) in restaurants. Results indicated that risky food preparation practices were commonly reported. Respondents said that at work they did not always wear gloves while touching ready-to-eat (RTE) food (60%), did not always wash their hands or change their gloves between handling raw meat and RTE food (23% and 33%), did not use a thermometer to check food temperatures (53%), and had worked while sick with vomiting or diarrhea (5%). Several factors were associated with safer food preparation practices. Workers responsible for food preparation reported washing their hands and wearing gloves when handling RTE food more often than workers not responsible for food preparation. Workers who cooked reported changing their gloves more often than workers who did not cook. Older workers and managers reported washing their hands more often than younger workers and non-managers. Workers in chain restaurants more frequently reported using thermometers than workers in independently owned restaurants. This study provides valuable information concerning the prevalence of food preparation practices and factors that may impact those practices. Additional research is needed to better understand those factors.

Adult↗

PubMed2005

Outbreaks of salmonellosis at elementary schools associated with dissection of owl pellets.

Salmonella enterica serotype Typhimurium outbreaks occurred at two elementary schools after science club students dissected owl pellets. Forty primary cases were identified (26 culture-confirmed). At the first school, pellets were dissected on a cafeteria table, concurrent with after-school child care in the cafeteria. Subsequently, the table was not sanitized before use by after-school care students for snack, or before the next school lunch. At the second school, pellets were dissected in a dedicated science room, and fewer cases occurred. Pellets in both outbreaks originated from a single captive barred owl. The outbreak pulsed-field gel electrophoresis subtype of S. Typhimurium was isolated from the owl's pellets and feces, and from four frozen chicks from a batch used to feed the owl.

Animals↗

PubMed2004

Dramatic decrease in the incidence of Salmonella serotype Enteritidis infections in 5 FoodNet sites: 1996-1999.

Salmonella serotype Enteritidis (SE) emerged as the most common Salmonella serotype among infected persons in the United States during the 1980s and 1990s, with infections reaching a peak in 1995. During the past decade, farm-to-table control measures have been instituted in the United States, particularly in regions with the highest incidence of SE infection. We report trends in the incidence of SE in the 5 original surveillance areas of the Foodborne Diseases Active Surveillance Network during 1996-1999: Minnesota, Oregon, and selected counties in California, Connecticut, and Georgia. Overall, the incidence of SE decreased 46% from 1996 to 1999. The greatest decrease was in Connecticut (71%), followed by northern California (50%), Minnesota (46%), and Oregon (13%). Although SE infection remains an important public health concern, there has been a remarkable decrease in its incidence. This decrease may be a result of targeted interventions, including on-farm control measures, refrigeration, and education efforts.

Female↗

PubMed2004

Burden of self-reported acute diarrheal illness in FoodNet surveillance areas, 1998-1999.

To assess trends in the burden of acute diarrheal illness, the Foodborne Diseases Active Surveillance Network (FoodNet) conducted a population-based telephone survey during 1998-1999, using a random-digit-dialing, single-stage Genesys-ID sampling method. During the 12-month study period, 12,755 persons were interviewed; after the exclusion of persons with chronic diarrheal illnesses, 12,075 persons were included in the analysis; 6% (n=645) reported having experienced an acute diarrheal illness at some point during the 4 weeks preceding the interview (annualized rate, 0.72 episodes per person-year). Rates of diarrheal illness were highest among children aged <5 years (1.1 episodes per person-year) and were lowest in persons aged > or =65 years (0.32 episodes per person-year). Twenty-one percent of persons with acute diarrheal illness sought medical care as a result of their illness. Diarrheal illness imposes a considerable burden on the US population and health care system.

Acute Disease↗

PubMed2002

A waterborne outbreak of Norwalk-like virus among snowmobilers-Wyoming, 2001.

In February 2001, episodes of acute gastroenteritis were reported to the Wyoming Department of Health from persons who had recently vacationed at a snowmobile lodge in Wyoming. A retrospective cohort study found a significant association between water consumption and illness, and testing identified Norwalk-like virus (NLV) in 8 of 13 stool samples and 1 well. Nucleotide sequences from the positive well-water specimen and 6 of the positive stool samples were identical. This multistrain NLV outbreak investigation illustrates the importance of NLV as a cause of waterborne illness and should encourage monitoring for NLVs in drinking water.

Caliciviridae Infections↗