MMWR News Synopsis for February 19, 2015

Update on Progress in Selected Public Health Programs After the 2010 Earthquake and Cholera Epidemic — Haiti, 2014

CDC Media Relations
404-639-3286

Despite the devastating 2010 earthquake and subsequent cholera epidemic, Haiti has made tremendous progress in improving the health of its people and the capacity of its health system, with the support of the U.S. Centers for Disease Control and Prevention (CDC). Continued assistance from CDC will allow this progress to be sustained and to serve as a model for other countries recovering from natural or man-made disasters, including those affected by Ebola. On January 12, 2010, an earthquake devastated Haiti’s infrastructure, killing an estimated 230,000 persons and displacing more than 1.5 million. Ten months later, Haiti experienced the beginning of the largest cholera epidemic ever reported in a single country. As part of a multi-sector, post-earthquake response in collaboration with the Government of Haiti and others, CDC focused on supporting the recovery, expansion, or establishment of several key health programs. Over the last five years, Haiti has made great progress in scaling up a wide range of health services, including HIV/AIDS, malaria, immunization, lymphatic filariasis, rabies, tuberculosis, and cholera, as well as in broader health systems capacity development. CDC is working with the Government of Haiti to sustain these gains and promote broader global health security objectives.

Hypothermia-Related Deaths — Wisconsin, 2014, and United States, 2003–2013

CDC Media Relations
404-639-3286

Public health efforts to reduce hypothermia-related deaths should focus on at-risk groups, particularly older persons and persons who live alone. Exposure to extreme cold is a leading cause of preventable weather-related mortality in the United States. Risks for hypothermia-related death include advanced age, mental illness, male sex, and drug intoxication. An analysis of death records showed that rates of hypothermia-related deaths increased in the United States during 2003–2012. A review of death investigations in Wisconsin revealed social isolation to be an important factor in hypothermia-related mortality. State and local health agencies can target public education and interventions to socially isolated groups, including older persons, the homeless, and those living alone.

Outbreak of Salmonella Newport Infections Linked to Cucumbers — United States, 2014

CDC Media RelationsZ
404-639-3286

Epidemiologic data, traceback investigations, and whole genome sequencing all support the hypothesis that cucumbers were a likely source of Salmonella Newport infections in this multistate outbreak originating in the Delmarva Peninsula of the Eastern United States. The epidemiologic data, traceback investigations, and whole genome sequencing all support the hypothesis that cucumbers were a likely source of Salmonella Newport infections in this outbreak. This is the first multistate outbreak of Salmonella Newport implicating a fresh produce item grown in the Delmarva region other than tomatoes. Investigating illness subclusters can provide critical clues about the source of an outbreak and advanced molecular detection methods, including WGS, might improve discrimination of subclusters during outbreak investigations. WGS data from the subclusters in this investigation demonstrated a phylogenetic link between clinical isolates from the eight Maryland and Delaware subclusters, in addition to differentiating these clusters from a subcluster in New York.

Hepatitis A Outbreak Among Adults with Developmental Disabilities in Group Homes — Michigan, 2013

Jennifer Smith
Michigan Department of Community Health
517-241-2112

While the overall incidence of hepatitis A virus (HAV) infections has decreased in the United States, outbreaks can occur among populations that are particularly vulnerable, including those living in group homes for persons with developmental disabilities. During April–July 2013, eight unvaccinated residents of five group homes for adults with disabilities in Michigan were diagnosed with HAV and one died. Disabled adults are now typically cared for in group homes where residents live in close quarters and are often incontinent and non-verbal. These factors, as well as lack of contact precautions and hand washing, may have contributed to the spread of HAV in this outbreak. While the overall number of HAV infections in the U.S. has declined with vaccination coverage, improvements in care, and fewer people institutionalized, this report demonstrates the continued risk of HAV infections among individuals living and working in group homes and highlights the public health resources needed to respond to these outbreaks. The authors note that public health response plans for the management of HAV outbreaks should include pre-identification of sources of immunoglobulin, which provides short-term protection against the development of infection, and hepatitis A vaccine. Routine vaccination of residents and staff of group homes should also be considered.

Notes from the Field: 

Fatal Gastrointestinal Mucormycosis in a Premature Infant Associated with Exposure to a Contaminated Dietary Supplement — Connecticut 2014

Use of Unvalidated Urine Mycotoxin Tests for the Clinical Diagnosis of Illness — United States, 2014

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES