Impact of 2012 West Nile virus outbreak on pesticide exposures reported to Texas poison centers. (No abstract available.)
Forrester MB, Gardner M.
TPHA J 2013;65(2):11-13.
Cancer Screenings throughout Texas, 2008 and 2010 Behavioral Risk Factor Surveillance System.
Cook M, Maynard W, Wyatt S, Garcia B.
Texas Public Health Journal. Winter 2013;65(1):8-13.
The article presents a study on the monitoring and screening of cancer in Texas in 2008 and 2010. It looks into the establishment of the Cancer Prevention Research Institute of Texas (CPRIT) and its effort to increase evidence-based screening for cancers of the breast, cervix, and colon and rectum. It explores the estimates of screening rates in the state.
Comparison of Pediatric Exposures to Concentrated "Pack" and Traditional Laundry Detergents.
Forrester MB.
Pediatr Emerg Care 2013 [Epub ahead of print]
Objectives: Pediatric exposures to concentrated laundry detergent packs may result in serious adverse effects. This study compared pediatric exposures to laundry detergent packs and traditional laundry detergents. Methods: Cases were exposures among patients 5 years or younger to laundry detergent packs during January to June 2012 and traditional laundry detergents during January to December 2011 reported to Texas poison centers. Comparisons between the 2 types of products were made for various variables. Results: Of 187 laundry detergent pack and 452 traditional laundry detergent exposures, the patient was already at or en route to a health care facility in 21.4% of the laundry detergent pack and 9.3% of the traditional laundry detergent exposures. Of those exposures where the poison center could potentially influence where the patient was managed, 23.8% of laundry detergent pack and 3.7% of traditional laundry detergent exposures were referred to health care facilities. Potentially serious outcomes were reported in 12.3% of laundry detergent pack and 2.4% of traditional laundry detergent exposures. The most commonly reported clinical effects in laundry detergent pack and traditional laundry detergent exposures were vomiting (54.5% vs 17.0%), cough (11.2% vs 2.2%), ocular irritation (7.0% vs 6.4%), red eye (7.0% vs 5.3%), nausea (7.0% vs 2.7%), and oral irritation (7.0% vs 2.2%). Conclusions: Pediatric exposures to laundry detergent packs were more likely to be managed at a health care facility. Moreover, the laundry detergent pack exposures were more likely to result in serious outcomes and involve the most common clinical effects.
National Outbreak of Type A Foodborne Botulism Associated with a Widely Distributed Commercially Canned Hot Dog Chili Sauce.
Juliao PC, Maslanka S, Dykes J, Gaul L, Bagdure S, Granzow-Kibiger L, Salehi E, Zink D, Neligan RP, Barton-Behravesh C, Lúquez C, Biggerstaff M, Lynch M, Olson C, Williams I, Barzilay EJ.
Clin Infect Dis. 2013 Feb;56(3):376-82.
A type A botulism outbreak was associated with commercially canned food; it is the first botulism outbreak in the United States involving a commercial cannery in >30 years. Because of possible widespread distribution of the implicated product, this outbreak was a major public health concern. Background: On 7 and 11 July 2007, health officials in Texas and Indiana, respectively, reported 4 possible cases of type A foodborne botulism to the US Centers for Disease Control and Prevention. Foodborne botulism is a rare and sometimes fatal illness caused by consuming foods containing botulinum neurotoxin. Methods: Investigators reviewed patients’ medical charts and food histories. Clinical specimens and food samples were tested for botulinum toxin and neurotoxin-producing Clostridium species. Investigators conducted inspections of the cannery that produced the implicated product. Results: Eight confirmed outbreak associated cases were identified from Indiana (n = 2), Texas (n = 3), and Ohio (n = 3). Botulinum toxin type A was identified in leftover chili sauce consumed by the Indiana patients and 1 of the Ohio patients. Cannery inspectors found violations of federal canned-food regulations that could have led to survival of Clostridium botulinum spores during sterilization. The company recalled 39 million cans of chili. Following the outbreak, the US Food and Drug Administration inspected other canneries with similar canning systems and issued warnings to the industry about the danger of C. botulinum and the importance of compliance with canned food manufacturing regulations. Conclusions: Commercially produced hot dog chili sauce caused these cases of type A botulism. This is the first US foodborne botulism outbreak involving a commercial cannery in >30 years. Sharing of epidemiologic and laboratory findings allowed for the rapid identification of implicated food items and swift removal of potentially deadly products from the market by US food regulatory authorities.
Emergence of Autochthonous Cutaneous Leishmaniasis in Northeastern Texas and Southeastern Oklahoma.
Clarke CF, Bradley KK, Wright JH, Glowicz J.
Am J Trop Med Hyg. 2013 Jan;88(1):157-61.
Autochthonous human cases of leishmaniasis in the United States are uncommon. We report three new cases of cutaneous leishmaniasis and details of a previously reported case, all outside the known endemic range in Texas. Surveys for enzootic rodent reservoirs and sand fly vectors were conducted around the residences of three of the case-patient during the summer of 2006; female Lutzomyia anthophora sand flies were collected at a north Texas and southeast Oklahoma residence of a case-patient, indicating proximity of a suitable vector. Urban sprawl, climatologic variability, or natural expansion of Leishmania mexicana are possible explanations for the apparent spread to the north and east. Enhanced awareness among healthcare providers in the south central region of the United States is important to ensure clinical suspicion of leishmaniasis, diagnosis, and appropriate patient management.
Disparities in the Treatment and Outcomes of Lung Cancer among HIV-infected People in Texas.
Suneja G, Shiels MS, Melville SK, Williams MA, Rengan R, Engels EA.
AIDS. 2013 Jan 28;27(3):459-68.
Objectives:: HIV-infected people have elevated risk for lung cancer and higher mortality following cancer diagnosis than HIV-uninfected individuals. It is unclear whether HIV-infected people with lung cancer receive similar cancer treatment as HIV-uninfected people. Design/Methods: We studied adults 18+ years old with lung cancer reported to the Texas Cancer Registry (N = 156,930) from 1995-2009. HIV status was determined by linkage with the Texas enhanced HIV/AIDS Reporting System. For non-small cell lung cancer (NSCLC) cases, we identified predictors of cancer treatment using logistic regression. We used Cox regression to evaluate effects of HIV and cancer treatment on mortality. Results: Compared with HIV-uninfected lung cancer cases (N = 156,593), HIV-infected lung cancer cases (N = 337) were more frequently young, non-Hispanic black, male, and with distant stage disease. HIV-infected NSCLC cases less frequently received cancer treatment than HIV-uninfected cases (60.3% vs. 77.5%; odds ratio 0.39, 95% confidence interval [CI] 0.30-0.52, after adjustment for diagnosis year, age, sex, race, stage, and histologic subtype). HIV infection was associated with higher lung cancer-specific mortality (hazard ratio [HR] 1.34, 95%CI 1.15-1.56, adjusted for demographics and tumor characteristics). Inclusion of cancer treatment in adjusted models slightly attenuated the effect of HIV on lung cancer-specific mortality (HR 1.25; 95%CI 1.06-1.47). Also, there was a suggestion that HIV was more strongly associated with mortality among untreated than among treated cases (adjusted HR 1.32 vs. 1.16, p-interaction = 0.34). Conclusion: HIV-infected NSCLC cases were less frequently treated for lung cancer than HIV-uninfected cases, which may have affected survival.
From Model to Action: Using a System Dynamics Model of Chronic Disease Risks to Align Community Action.
Loyo HK, Batcher C, Wile K, Huang P, Orenstein D, Milstein B.
Health Promot Pract. 2013 Jan;14(1):53-61.
Health planners in Austin, Texas, are using a System Dynamics Model of Cardiovascular Disease Risks (SD model) to align prevention efforts and maximize the effect of limited resources. The SD model was developed using available evidence of disease prevalence, risk factors, local contextual factors, resulting health conditions, and their impact on population health. Given an interest in understanding opportunities for upstream health protection, the SD model focused on the portion of the population that has never had a cardiovascular event. Leaders in Austin used this interactive simulation model as a catalyst for convening diverse stakeholders in thinking about their strategic directions and policy priorities. Health officials shared insights from the model with a range of organizations in an effort to align actions and leverage assets in the community to promote healthier conditions for all. This article summarizes the results from several simulated intervention scenarios focusing specifically on conditions in East Travis County, an area marked by higher prevalence of adverse living conditions and related chronic diseases. The article also describes the formation of a new Chronic Disease Prevention Coalition in Austin, along with shifts in its members perceived priorities for intervention both before and after interactions with the SD model.
West Nile Virus Infection among Humans, Texas, USA, 2002-2011.
Nolan M, Schuermann J, Murray K.
Emerg Infect Dis. 2013 Jan;19(1):137-9.
We conducted an epidemiologic analysis to document West Nile virus infections among humans in Texas, USA, during 2002-2011. West Nile virus has become endemic to Texas; the number of reported cases increased every 3 years. Risk for infection was greatest in rural northwestern Texas, where Culex tarsalis mosquitoes are the predominant mosquito species.
Pediatric Insecticide Chalk Exposures Reported to Texas Poison Centers.
Forrester MB.
Hum Exp Toxicol 2013;32:501-505.
The pesticide Miraculous Insecticide Chalk is illegal in the United States but can be obtained through a variety of sources. Because it is a stick similar in appearance to common blackboard chalk, children might play with it and put it in their mouths. All Miraculous Insecticide Chalk exposures involving children 5 years or younger reported to Texas poison centers during 2000-2010 were identified. The distribution by selected demographic and clinical factors was calculated. Of the total 188 exposures, the mean age was 1.5 years (range 6 months-5 years) and 60.6% were male. Ingestions were reported in 97.3% of the exposures, and these were reported to involve at most one stick of the chalk. The lowest exposure rates per 100,000 population of 5 years or younger were reported in the Public Health Regions in northern and eastern Texas (0.00-2.30) and the highest rates in the Public Health Regions in southern and western Texas (19.08-39.50). Of the 187 exposures not involving other substances, 96.8% were known or expected to result in at most minor effects, and 71.1% were managed on site (at residence).
Reporting of Bedbug Treatment Exposures to Texas Poison Centres
Forrester MB, Prosperie S.
Public Health. 2013 Mar 12. [Epub ahead of print] (No abstract available.)
Adolescent Synthetic Cathinone Exposures Reported to Texas Poison Centers.
Forrester MB.
Pediatr Emerg Care 2013 [Epub ahead of print]
Objectives: This study describes the pattern of adolescent synthetic cathinone exposures reported to a large, statewide poison center system. Methods: Synthetic cathinone exposures among patients younger than 20 years reported to Texas poison centers during 2010 to 2011 were identified. The distribution of exposures by various demographic and clinical factors was determined. Results: For 51 adolescent exposures, the mean age was 17.5 years (range, 12-19 years). The exposure was by inhalation in 66.7% of the cases and 60.8% involved male patients. The exposure site was the patient's own or another residence in 58.8% of the cases. The patient was already at or en route to a health care facility in 76.5% of the cases, and the medical outcome was known or suspected to be serious in 74.5%. The most frequently reported adverse clinical effects were agitation/irritability (43.1%), tachycardia (37.3%), drowsiness/lethargy (13.7%), hallucinations (9.8%), fever (9.8%), vomiting (9.8%), and hypertension (7.8%). Conclusions: Adolescent synthetic cathinone exposures reported to Texas poison centers were more likely to have occurred by inhalation. The adolescents were more likely to be male. The exposures more often occurred at the patient's own residence and were managed at a health care facility with a serious outcome. This pattern of exposures was similar to that observed among adults.