Multistate outbreak of respiratory infections among unaccompanied children, June-July 2014

Details

• Personal Author:
  Arriola CS ; Beall B ; Benitez A ; Benoit SR ; Berman L ; Bresee J ; Cohn A ; Cross K ; da Gloria Carvalho M ; Diaz MH ; Francois Watkins LK ; Gierke R ; Hagan JE ; Harris A ; Jain S ; Kim C ; Kim L ; Kobayashi M ; Lindstrom S ; McGee L ; McMorrow M ; Metcalf BL ; Moore MR ; Moura I ; Nix WA ; Nyangoma E ; Oberste MS ; Olsen SJ ; Pimenta F ; Socias, Christina ; Thurman K ; Tomczyk S ; Waller J ; Waterman SH ; Westercamp M ; Wharton M ; Whitney CG ; Winchell JM ; Wolff B
• Description:
  BACKGROUND: From January-July 2014, >46,000 unaccompanied children (UC) from Central America crossed the U.S.-Mexico border. In June-July, UC aged 9-17 years in four shelters and a processing center in four U.S. states were hospitalized with acute respiratory illness. We conducted a multistate investigation to interrupt disease transmission. METHODS: Medical charts were abstracted for hospitalized UC. Non-hospitalized UC with influenza-like illness were interviewed, and nasopharyngeal and oropharyngeal swabs for PCR-based detection of respiratory pathogens were collected. Nasopharyngeal swabs were used to assess pneumococcal colonization in symptomatic and asymptomatic UC. Pneumococcal blood isolates from hospitalized UC and nasopharyngeal isolates were characterized by serotyping (Quellung) and whole-genome sequencing. RESULTS: Among the 15 hospitalized UC, 4 (44%) of 9 tested positive for influenza viruses, and 6 (43%) of 14 with blood cultures grew pneumococcus, all serotype 5. Among 48 non-hospitalized children with influenza-like illness, >1 respiratory pathogen was identified in 46 (96%). Among 774 non-hospitalized UC, 185 (24%) yielded pneumococcus, and 70 (38%) were serotype 5. UC who transferred through the processing center were more likely than others to be colonized with serotype 5 (OR 3.8; 95% CI, 2.1-6.9). Analysis of the core pneumococcal genomes detected two related, yet independent, clusters. No pneumococcus cases were reported after pneumococcal and influenza immunization campaigns were implemented. CONCLUSIONS: This outbreak of respiratory disease was due to multiple pathogens, including Streptococcus pneumoniae serotype 5 and influenza viruses. Pneumococcal and influenza vaccinations prevented further transmission. Future efforts to prevent similar outbreaks will benefit from use of both vaccines. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Influenza, Human Lung Diseases Occupational Health Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Children Flu Infectious Diseases Influenza Lung Disease Pneumonia Respiratory Infections Respiratory System Disorders
• ISSN:
  1058-4838
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Georgia ; OSHA Region 3 ; OSHA Region 4 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  48-56
• Volume:
  63
• Issue:
  1
• NIOSHTIC Number:
  nn:20047752
• Citation:
  Clin Infect Dis 2016 Jul; 63(1):48-56
• Contact Point Address:
  Sara Tomczyk, PHN, MSc, Centers for Disease Control and Prevention, 1600 Clifton Road, MS C-25, Atlanta, GA 30329
• Email:
  xdj2@cdc.gov
• Federal Fiscal Year:
  2016
• Peer Reviewed:
  True
• Source Full Name:
  Clinical Infectious Diseases
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:efc8844c526d70c471360476a8d365c7db67fb89e65a3b073374c578d9b0a3c14bbe10eeae88aea1aee59705acdce75a499642aed122a6afe466b08fff8fb2d4
• Download URL:
  https://stacks.cdc.gov/view/cdc/202743/cdc_202743_DS1.pdf
• File Type:
  [PDF - 344.72 KB ]