Emilio E. DeBess

In Oregon, human and animal infections by C. gattii were first identified in 2004. Cryptococcus gattii is considered to be an emerging non-zoonotic infection affecting animals and humans in Oregon. We report a longitudinal environmental isolation of C. gattii after an Oregon dog was diagnosed with the disease in 2009. Cryptococcus gattii was isolated twice from the same location with a span of one year between isolation dates. Cryptococcus gattii molecular types VGIIa and VGI were isolated in 2010 from soil and tree bark near the home of a 9-month-old dog which three months previously had an infection caused by C. gattii genotype VGIIa. The environment featured heavy growth of Douglas Fir trees. In 2011, a second set of soil and tree bark samples was collected in the same area and C. gattii VGIIa was again identified from the environment, along with genotypes VGIIb and VGIIc. The use of animal surveillance data to identify environmental niches of C. gattii should be considered to expand the understanding of this emerging pathogen. Understanding the ecology and how the environment and other factors might modify the existing niches is important for assessing risk and for designing measures to protect human and animal health.

To evaluate trends in and risk factors for acquisition of antimicrobial-drug resistant nontyphoidal Salmonella infections, we searched Oregon surveillance data for 2004–2009 for all culture-confirmed cases of salmonellosis. We defined clinically important resistance (CIR) as decreased susceptibility to ampicillin, ceftriaxone, ciprofloxacin, gentamicin, or trimethoprim/sulfamethoxazole. Of 2,153 cases, 2,127 (99%) nontyphoidal Salmonella isolates were obtained from a specific source (e.g., feces, urine, blood, or other normally sterile tissue) and had been tested for drug susceptibility. Among these, 347 (16%) isolates had CIR. The odds of acquiring CIR infection significantly increased each year. Hospitalization was more likely for patients with than without CIR infections. Among patients with isolates that had been tested, we analyzed data from 1,813 (84%) who were interviewed. Travel to eastern or Southeast Asia was associated with increased CIR. Isolates associated with outbreaks were less likely to have CIR. Future surveillance activities should evaluate resistance with respect to international travel.

BACKGROUND: School‐located vaccination clinics offer an opportunity to target children for vaccination programs during communicable disease outbreaks. However, children in the United States are primarily vaccinated in the pediatrician's or family physician's office, and the concept of school‐located vaccinations may be unfamiliar to some parents and guardians. Physician support could contribute to effective implementation of school‐located vaccination clinics during outbreak situations. The primary objective of the study was to assess physician opinion of using school‐located vaccination clinics to administer both outbreak‐specific and routine vaccines.METHODS: A statewide mail and Internet survey was administered to 275 pediatricians and 275 family physicians in Oregon during July and August 2010.RESULTS: Ninety‐one percent of physicians supported the use of school‐located vaccination clinics as immunization delivery sites during outbreak situations. Sixty percent of physicians supported using school‐located vaccination clinics to administer routine vaccinations. Only 57% of physicians had knowledge of school‐located vaccination clinic availability to their patients.CONCLUSIONS: Pediatricians and family physicians expressed strong support of school vaccination clinics as sites for immunization delivery during outbreak situations but significantly less support for administering routine vaccinations. Increasing physician awareness of school‐located vaccination clinic availability and establishing partnerships between physician practices and school vaccination clinics may improve access to immunizations for school‐aged children and adolescents, particularly during large‐scale communicable disease outbreaks.

This survey reports on the knowledge and practices of 407 food handlers (FHs) working at 67 randomly selected restaurants in Washington and Marion counties in Oregon. During April–September 2000, a 28-question survey distilled from a longer survey obtained from the Oregon Food Handler Certification Program was administered in writing. FHs present at the time of visit were surveyed regarding their knowledge of food safety and prevention of foodborne illness. The average score on the FH survey was 68%. Of the 407 participants, 84% were line staff and 16% were managers, 56% were women and 44% men, 68% were English-speaking Whites, 19% were Spanish-speaking Hispanics, 9% were Asian, and 42% had some college education. Managers scored 74%, while line staff scored 67%. Women scored 69%, and men scored 66%. Non-Hispanic Whites scored 72%, and Spanish-speaking Hispanics scored 54%. FH staff who reported some college education scored 73%, and those who did not report any college education scored 64%. Those with a food handlers card (FHC) scored 69%, while those without an FHC scored 63%. The results demonstrate a lack of food-safety knowledge among FHs that may result in the transmission of foodborne pathogens to the public during food preparation. Survey scores emphasize the need for educational programs to improve workers' knowledge of foodborne diseases and their transmission. The scores also illustrate the need for Spanish language education in food safety in these two counties.