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  1. Article ; Online: Implications of Measles Inclusion by Commercial Syndromic Polymerase Chain Reaction Panels - United States, May 2022-April 2023.

    Thomas, Christine M / Hartley, Amanda / Schmitz, Ann / Reid, Heather D / Sullivan, Susan / Huebner, Elise / Robinson, Meredith / Mathis, Adria / Fill, Mary-Margaret A / Levinson, Kara J / Jones, Tim F / Schaffner, William / Newhouse, Caitlin N / Dunn, John R

    MMWR. Morbidity and mortality weekly report

    2024  Volume 73, Issue 12, Page(s) 260–264

    Abstract: Syndromic polymerase chain reaction (PCR) panels are used to test for pathogens that can cause rash illnesses, including measles. Rash illnesses have infectious and noninfectious causes, and approximately 5% of persons experience a rash 7-10 days after ... ...

    Abstract Syndromic polymerase chain reaction (PCR) panels are used to test for pathogens that can cause rash illnesses, including measles. Rash illnesses have infectious and noninfectious causes, and approximately 5% of persons experience a rash 7-10 days after receipt of a measles, mumps, and rubella (MMR) vaccine. MMR vaccine includes live attenuated measles virus, which is detectable by PCR tests. No evidence exists of person-to-person transmission of measles vaccine virus, and illness does not typically result among immunocompetent persons. During September 2022-January 2023, the Tennessee Department of Health received two reports of measles detected by syndromic PCR panels. Both reports involved children (aged 1 and 6 years) without known risk factors for measles, who were evaluated for rash that occurred 11-13 days after routine MMR vaccination. After public health responses in Tennessee determined that both PCR panels had detected measles vaccine virus, six state health departments collaborated to assess the frequency and characteristics of persons receiving a positive measles PCR panel test result in the United States. Information was retrospectively collected from a commercial laboratory testing for measles in syndromic multiplex PCR panels. During May 2022-April 2023, among 1,548 syndromic PCR panels, 17 (1.1%) returned positive test results for measles virus. Among 14 persons who received a positive test result and for whom vaccination and case investigation information were available, all had received MMR vaccine a median of 12 days before specimen collection, and none had known risk factors for acquiring measles. All positive PCR results were attributed to detection of measles vaccine virus. Increased awareness among health care providers about potential measles detection by PCR after vaccination is needed. Any detection of measles virus by syndromic PCR testing should be immediately reported to public health agencies, which can use measles vaccination history and assessment of risk factors to determine the appropriate public health response. If a person recently received MMR vaccine and has no risk factors for acquiring measles, additional public health response is likely unnecessary.
    MeSH term(s) Child ; Humans ; United States/epidemiology ; Infant ; Measles-Mumps-Rubella Vaccine ; Retrospective Studies ; Measles/diagnosis ; Measles/epidemiology ; Measles/prevention & control ; Measles virus/genetics ; Mumps/prevention & control ; Vaccination ; Tennessee/epidemiology ; Exanthema ; Polymerase Chain Reaction ; Rubella/prevention & control ; Antibodies, Viral
    Chemical Substances Measles-Mumps-Rubella Vaccine ; Antibodies, Viral
    Language English
    Publishing date 2024-03-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 412775-4
    ISSN 1545-861X ; 0149-2195
    ISSN (online) 1545-861X
    ISSN 0149-2195
    DOI 10.15585/mmwr.mm7312a3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Systematic environmental evaluations to identify food safety differences between outbreak and nonoutbreak restaurants.

    Hedberg, Craig W / Smith, S Jay / Kirkland, Elizabeth / Radke, Vincent / Jones, Tim F / Selman, Carol A

    Journal of food protection

    2005  Volume 69, Issue 11, Page(s) 2697–2702

    Abstract: Restaurants are important settings for foodborne disease transmission. The Environmental Health Specialists Network (EHS-Net) was established to identify underlying factors contributing to disease outbreaks and to translate those findings into improved ... ...

    Abstract Restaurants are important settings for foodborne disease transmission. The Environmental Health Specialists Network (EHS-Net) was established to identify underlying factors contributing to disease outbreaks and to translate those findings into improved prevention efforts. From June 2002 through June 2003, EHS-Net conducted systematic environmental evaluations in 22 restaurants in which outbreaks had occurred and 347 restaurants in which outbreaks had not occurred. Norovirus was the most common foodborne disease agent identified, accounting for 42% of all confirmed foodborne outbreaks during the study period. Handling of food by an infected person or carrier (65%) and bare-hand contact with food (35%) were the most commonly identified contributing factors. Outbreak and nonoutbreak restaurants were similar with respect to many characteristics. The major difference was in the presence of a certified kitchen manager (CKM); 32% of outbreak restaurants had a CKM, but 71% of nonoutbreak restaurants had a CKM (odds ratio of 0.2; 95% confidence interval of 0.1 to 0.5). CKMs were associated with the absence of bare-hand contact with foods as a contributing factor, fewer norovirus outbreaks, and the absence of outbreaks associated with Clostridium perfringens. However, neither the presence of a CKM nor the presence of policies regarding employee health significantly affected the identification of an infected person or carrier as a contributing factor. These findings suggest a lack of effective monitoring of employee illness or a lack of commitment to enforcing policies regarding ill food workers. Food safety certification of kitchen managers appears to be an important outbreak prevention measure, and managing food worker illnesses should be emphasized during food safety training programs.
    MeSH term(s) Caliciviridae Infections/epidemiology ; Caliciviridae Infections/prevention & control ; Consumer Product Safety ; Disease Outbreaks ; Food Handling/methods ; Food Handling/standards ; Food Microbiology ; Food Services/standards ; Foodborne Diseases/epidemiology ; Foodborne Diseases/prevention & control ; Gastroenteritis/epidemiology ; Gastroenteritis/prevention & control ; Humans ; Hygiene ; Norovirus/isolation & purification ; Restaurants/standards ; Risk Assessment ; Risk Factors ; United States/epidemiology
    Language English
    Publishing date 2005-11-21
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 243284-5
    ISSN 1944-9097 ; 0362-028X
    ISSN (online) 1944-9097
    ISSN 0362-028X
    DOI 10.4315/0362-028x-69.11.2697
    Database MEDical Literature Analysis and Retrieval System OnLINE

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