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OBJECTIVE: To provide epidemiological information on animal and human cases of rabies occurring in the United States during 2019 and summaries of 2019 rabies surveillance for Canada and Mexico. ANIMALS: All animals submitted for laboratory diagnosis of rabies in the United States during 2019. PROCEDURES: State and territorial public health departments and USDA Wildlife Services provided data on animals submitted for rabies testing in the United States during 2019. Data were analyzed temporally and geographically to assess trends in domestic and wildlife rabies cases. RESULTS: During 2019, 53 jurisdictions submitted 97,523 animal samples for rabies testing, of which 94,770 (97.2%) had a conclusive (positive or negative) test result. Of these, 4,690 tested positive for rabies, representing a 5.3% decrease from the 4,951 cases reported in 2018. Texas (n = 565 [12.0%]), New York (391 [8.3%]), Virginia (385 [8.2%]), North Carolina (315 [6.7%]), California (276 [5.9%]), and Maryland (269 [5.7%]) together accounted for almost half of all animal rabies cases reported in 2019. Of the total reported rabid animals, 4,305 (91.8%) were wildlife, with raccoons (n = 1,545 [32.9%]), bats (1,387 [29.6%]), skunks (915 [19.5%]), and foxes (361 [7.7%]) as the primary species confirmed with rabies. Rabid cats (n = 245 [5.2%]) and dogs (66 [1.4%]) accounted for > 80% of rabies cases involving domestic animals in 2019. No human rabies cases were reported in 2019. CONCLUSIONS AND CLINICAL RELEVANCE: The overall number of animal rabies cases decreased from 2018 to 2019. Laboratory diagnosis of rabies in animals is critical to ensure that human rabies postexposure prophylaxis is administered judiciously.
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Doenças do Gato , Quirópteros , Doenças do Cão , Raiva , Animais , Animais Domésticos , Animais Selvagens , Canadá , Gatos , Doenças do Cão/epidemiologia , Cães , México , New York , North Carolina , Vigilância da População , Raiva/epidemiologia , Raiva/prevenção & controle , Raiva/veterinária , Guaxinins , Texas , Estados Unidos/epidemiologia , VirginiaRESUMO
It is important to understand genetics within the context of health. This paper assesses (a) genetic knowledge among Mexican-born farmworker and non-farmworker adults; (b) their interpersonal and device sources of genetic knowledge; and (c) the association between their genetic knowledge and the sources of this genetic knowledge.Interviews were conducted with Mexican-born farmworkers (100) and non-farmworkers (100) in North Carolina. Participants answered 15 questions to assess genetic knowledge, and sources from which they had seen or heard about genes and genetics.Results show limited knowledge of genetics, with farmworkers and non-farmworkers providing a similar level of correct responses (6.6 versus 7.3), but with farmworkers providing more incorrect responses (4.0 versus 2.7). Important sources of genetic information for farmworkers were promotoras (47%), compared to teachers (49%) for non-farmworkers.This study demonstrates a need for increased dissemination of genetic information to Mexican-origin farmworkers and non-farmworkers.
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Fazendeiros , Migrantes , Adulto , Agricultura , Comunicação , Hispânico ou Latino , Humanos , Conhecimento , México , North CarolinaRESUMO
Ascidians are prolific colonizers of new environments and possess a range of well-studied features that contribute to their successful spread, but the role of their symbiotic microbial communities in their long-term establishment is mostly unknown. In this study, we utilized next-generation amplicon sequencing to provide a comprehensive description of the microbiome in the colonial ascidian Clavelina oblonga and examined differences in the composition, diversity, and structure of symbiont communities in the host's native and invasive ranges. To identify host haplotypes, we sequenced a fragment of the mitochondrial gene cytochrome c oxidase subunit I (COI). C. oblonga harbored a diverse microbiome spanning 42 bacterial and three archaeal phyla. Colonies in the invasive range hosted significantly less diverse symbiont communities and exhibited lower COI haplotype diversity than colonies in the native range. Differences in microbiome structure were also detected across colonies in the native and invasive range, driven largely by novel bacteria representing symbiont lineages with putative roles in nitrogen cycling. Variability in symbiont composition was also observed among sites within each range. Together, these data suggest that C. oblonga hosts a dynamic microbiome resulting from (i) reductions in symbiont diversity due to founder effects in host populations and (ii) environmental selection of symbiont taxa in response to new habitats within a range. Further investigation is required to document the mechanisms behind these changes and to determine how changes in microbiome structure relate to holobiont function and the successful establishment of C. oblonga worldwide.IMPORTANCE Nonnative species destabilize coastal ecosystems and microbial symbionts may facilitate their spread by enhancing host survival and fitness. However, we know little of the microorganisms that live inside invasive species and whether they change as the host spreads to new areas. In this study, we investigated the microbial communities of an introduced ascidian (Clavelina oblonga) and tracked symbiont changes across locations within the host's native and invasive ranges. Ascidians in the invasive range had less-diverse microbiomes, as well as lower host haplotype diversity, suggesting that specific colonies reach new locations and carry select symbionts from native populations (i.e., founder effects). Further, ascidians in the invasive range hosted a different composition of symbionts, including microbes with the potential to aid in processes related to invasion success (e.g., nutrient cycling). We conclude that the putative functionality and observed flexibility of this introduced ascidian microbiome may represent an underappreciated factor in the successful establishment of nonnative species in new environments.
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Espécies Introduzidas , Microbiota , Urocordados/microbiologia , Animais , Bactérias/genética , Brasil , Código de Barras de DNA Taxonômico , Florida , Itália , North Carolina , RNA Ribossômico 16S/genética , Água do Mar , South Carolina , Espanha , Simbiose , Urocordados/genéticaRESUMO
This analysis describes beliefs about secondhand smoke and its health effects held by Mexican and Central American immigrants in North Carolina. Data from 60 semistructured, in-depth interviews were subjected to saliency analysis. Participant discussions of secondhand smoke centered on four domains: (1) familiarity and definition of secondhand smoke, (2) potency of secondhand smoke, (3) general health effects of secondhand smoke, and (4) child health effects of secondhand smoke. Secondhand smoke was generally believed to be more harmful than primary smoke. Mechanisms for the potency and health effects of secondhand smoke involved the smell of secondhand smoke, secondhand smoke being an infection and affecting the immune system, and personal strength being protective of secondhand smoke. Understanding these health beliefs informs a framework for further health education and intervention to reduce smoking and secondhand smoke exposure in this vulnerable population.
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Atitude Frente a Saúde , Emigrantes e Imigrantes , Poluição por Fumaça de Tabaco , Adolescente , Adulto , Idoso , América Central/etnologia , Criança , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , North Carolina/epidemiologia , Fumaça , Nicotiana , Poluição por Fumaça de Tabaco/efeitos adversos , Estados Unidos , Adulto JovemRESUMO
Concentrated swine production can produce large amounts of accumulated waste that may serve as development sites for pest flies. Filth flies are not only a nuisance but can also interfere with animal growth and production and are capable of mechanically transmitting many pathogens to swine on confinement facilities. In addition to production and health concerns, high populations of filth flies developing on concentrated animal facilities may subject producers to nuisance litigation. While litigation against livestock producers associated with pest filth flies has become more frequent and high profile, information on the filth fly fauna in swine facilities in the United States is limited. In this study, filth fly species diversity and population fluctuations were monitored with spot and sticky cards in one sow facility and two finishing facilities in North Carolina. House flies Musca domestica L. (Diptera: Muscidae) were the dominant species followed by black dump flies Hydrotea (Ophyra) aenescens Weidemann (Diptera: Muscidae). A difference was seen in total spots on cards placed in more central barn locations than towards the outer walls in the sow facility but not the finishing facilities. Mean spots at only one of the finishing facilities exceeded the conventional control threshold of 100 spots/week, in May and June. Fly numbers decreased naturally in the following months, suggesting that standard control thresholds may not accurately inform filth fly control efforts in swine production. Due to their complementary nature, both spot and sticky cards placed in representative locations throughout barns are recommended. However, more swine-specific information is needed for optimizing monitoring methods.
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Biota , Abrigo para Animais , Controle de Insetos/métodos , Muscidae/fisiologia , Animais , North Carolina , Dinâmica Populacional , Sus scrofaRESUMO
Serum soluble Fas (sFas) levels are associated with erythropoietin (Epo) hyporesponsiveness in patients with chronic kidney disease (CKD). Whether sFas could predict the need for erythropoiesis-stimulating agent (ESA) usage and its influence in erythropoiesis remain unclear. We evaluated the relation between sFas and ESA therapy in patients with CKD with anemia and its effect on erythropoiesis in vitro. First, we performed a retrospective cohort study with 77 anemic patients with nondialysis CKD. We performed in vitro experiments to investigate whether sFas could interfere with the behavior of hematopoietic stem cells (HSCs). HSCs were isolated from umbilical cord blood and incubated with recombinant sFas protein in a dose-dependent manner. Serum sFas positively correlated with Epo levels (r = 0.30, P = 0.001) but negatively with hemoglobin (r = -0.55, P < 0.001) and glomerular filtration rate (r = -0.58, P < 0.001) in patients with CKD at baseline. Elevated sFas serum levels (4,316 ± 897 vs. 2,776 ± 749, P < 0.001) with lower estimated glomerular filtration rate (26.2 ± 10.1 vs. 33.5 ± 14.3, P = 0.01) and reduced hemoglobin concentration (11.1 ± 0.9 vs. 12.5 ± 1.2, P < 0.001) were identified in patients who required ESA therapy compared with patients with non-ESA. Afterward, we detected that the sFas level was slight correlated with a necessity of ESA therapy in patients with nondialysis CKD and anemia. In vitro assays demonstrated that the erythroid progenitor cell frequency negatively correlated with sFas concentration (r = -0.72, P < 0.001). There was decreased erythroid colony formation in vitro when CD34+ HSCs were incubated with a higher concentration of sFas protein (1.56 ± 0.29, 4.33 ± 0.53, P < 0.001). Our findings suggest that sFas is a potential predictor for ESA therapy in patients with nondialysis CKD and that elevated sFas could affect erythropoiesis in vitro.
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Anemia/sangue , Eritropoese , Células-Tronco Hematopoéticas/metabolismo , Células-Tronco Multipotentes/metabolismo , Insuficiência Renal Crônica/complicações , Receptor fas/sangue , Adulto , Idoso , Anemia/diagnóstico , Anemia/tratamento farmacológico , Anemia/etiologia , Biomarcadores/sangue , Brasil , Células Cultivadas , Tomada de Decisão Clínica , Bases de Dados Factuais , Eritropoese/efeitos dos fármacos , Eritropoetina/sangue , Feminino , Hematínicos/uso terapêutico , Células-Tronco Hematopoéticas/efeitos dos fármacos , Hemoglobinas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Células-Tronco Multipotentes/efeitos dos fármacos , North Carolina , Seleção de Pacientes , Valor Preditivo dos Testes , Proteínas Recombinantes/farmacologia , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/diagnóstico , Estudos RetrospectivosRESUMO
Hurricane Dorian's impact on Eastern North Carolina and the Bahamas islands demonstrate the devastation and public health needs that can be left in the wake of a catastrophic event. The hurricane created a range of public health and healthcare challenges, strained further by the damage to infrastructure on which critical services, including the medical supply chain, depend. The recovery process is long, but offers an opportunity to build back better, more resilient communities that can withstand today's threats.
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Tempestades Ciclônicas/estatística & dados numéricos , Planejamento em Desastres/métodos , Bahamas , Planejamento em Desastres/normas , Planejamento em Desastres/tendências , Humanos , North Carolina , Saúde Pública/métodos , Saúde Pública/normas , Saúde Pública/tendênciasRESUMO
BACKGROUND: US government child labor policies allow children as young as age 10 to be hired as workers on farms not operated by family members. Children may face substantial health risks in an industry known for high worker morbidity and mortality rates, due to high demands for productivity, and low control and little support because of the organization of the workplace. This paper examines how child farmworkers in North Carolina experience their work situation. METHODS: In-depth interviews conducted in 2016 with 30 Latinx child farmworkers, ages 10 to 17, were analyzed using concepts from the demand-control-support model. All had worked as either migrant or seasonal hired farmworkers within the past year. RESULTS: Children reported planting, cultivating, and harvesting crops including fruits, vegetables, and tobacco. The crew leader supervisory system, piece-rate pay, and coworker pressure produced significant demands to work quickly and take risks including lifting heavy loads, operating mechanical equipment, and working in excessive heat. Children had little control over work to counter demands they experienced; and they labored in a state of fear of firing, wage theft, and other sanctions. Support was variable, with younger children more likely to experience family and coworker support than older children. CONCLUSIONS: The high demands with limited control and, for some, little support, that these children experience place them at risk and show the possibility of injury and exploitation. Future research should systematically document the occupational injury and illness of hired child farmworkers, and consider whether changes in labor policy are warranted.
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Agricultura , Trabalho Infantil , Fazendeiros , Carga de Trabalho , Adolescente , Agricultura/economia , Agricultura/métodos , Criança , Feminino , Guatemala/etnologia , Hispânico ou Latino , Humanos , Entrevistas como Assunto , Masculino , México/etnologia , North Carolina , Migrantes , Populações VulneráveisRESUMO
OBJECTIVE: To evaluate the performance of a 2-tiered newborn screening method for mucopolysaccharidosis type I (MPS I) in North Carolina. STUDY DESIGN: The screening algorithm included a flow injection analysis-tandem mass spectrometry assay as a first-tier screening method to measure α-L-iduronidase (IDUA) enzyme activity and Sanger sequencing of the IDUA gene on dried blood spots as a second-tier assay. The screening algorithm was revised to incorporate the Collaborative Laboratory Integrated Reports, an analytical interpretive tool, to reduce the false-positive rate. A medical history, physical examination, IDUA activity, and urinary glycosaminoglycan (GAG) analysis were obtained on all screen-positive infants. RESULTS: A total of 62 734 specimens were screened with 54 screen-positive samples using a cut-off of 15% of daily mean IDUA activity. The implementation of Collaborative Laboratory Integrated Reports reduced the number of specimens that screened positive to 19 infants. Of the infants identified as screen-positive, 1 had elevated urinary GAGs and a homozygous pathogenic variant associated with the severe form of MPS I. All other screen-positive infants had normal urinary GAG analysis; 13 newborns had pseudodeficiency alleles, 3 newborns had variants of unknown significance, and 2 had heterozygous pathogenic variants. CONCLUSIONS: An infant with severe MPS I was identified and referred for a hematopoietic stem cell transplant. Newborn IDUA enzyme deficiency is common in North Carolina, but most are due to pseudodeficiency alleles in infants with normal urinary GAG analysis and no evidence of disease. The pilot study confirmed the need for second-tier testing to reduce the follow-up burden.
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Mucopolissacaridose I/diagnóstico , Triagem Neonatal , Algoritmos , Dermatan Sulfato/urina , Testes Genéticos , Variação Genética , Glicosaminoglicanos/urina , Heparitina Sulfato/urina , Humanos , Iduronidase/sangue , Iduronidase/genética , Recém-Nascido , Mucopolissacaridose I/genética , North Carolina , Encaminhamento e Consulta/estatística & dados numéricos , Análise de Sequência , Espectrometria de Massas em TandemRESUMO
OBJECTIVE: To assess the performance of a standardized, age-based metric for scoring clinical actionability to evaluate conditions for inclusion in newborn screening and compare it with the results from other contemporary methods. STUDY DESIGN: The North Carolina Newborn Exome Sequencing for Universal Screening study developed an age-based, semiquantitative metric to assess the clinical actionability of gene-disease pairs and classify them with respect to age of onset or timing of interventions. This categorization was compared with the gold standard Recommended Uniform Screening Panel and other methods to evaluate gene-disease pairs for newborn genomic sequencing. RESULTS: We assessed 822 gene-disease pairs, enriched for pediatric onset of disease and suspected actionability. Of these, 466 were classified as having childhood onset and high actionability, analogous to conditions selected for the Recommended Uniform Screening Panel core panel. Another 245 were classified as having childhood onset and low to no actionability, 25 were classified as having adult onset and high actionability, 19 were classified as having adult onset and low to no actionability, and 67 were excluded due to controversial evidence and/or prenatal onset. CONCLUSIONS: This study describes a novel method to facilitate decisions about the potential use of genomic sequencing for newborn screening. These categories may assist parents and physicians in making informed decisions about the disclosure of results from voluntary genomic sequencing in children.