MMWR – Morbidity and Mortality Weekly Report

MMWR News Synopsis for February 27, 2014

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1. Histoplasmosis Associated with a Bamboo Bonfire — Arkansas, October 2011

When physicians see an individual with an illness consistent with histoplasmosis, they should ask about potentially ill contacts to be assured that the patient is not a member of an outbreak. Human infection with Histoplasma capsulatumoccurs sporadically and in outbreaks in endemic areas along the Ohio, Mississippi, and Missouri River valleys. Outbreaks classically have been observed in situations where individuals come in contact with disturbed ground, bird feces or bat guano. This outbreak report highlights a cluster of acute histoplasmosis cases among persons who attended a bonfire where bamboo, previously used as a blackbird roost, was burned. Observations from this outbreak raise the question whether exposure to a bonfire might be a newly recognized risk factor for histoplasmosis infection.

2. Multiple-Serotype Salmonella Outbreaks in Two State Prisons — Arkansas, August 2012

Ensuring prison staff and inmates involved in food service receive training and comply with state and local food preparation guidelines is key in preventing the occurrence and spread of foodborne outbreaks in prisons. Salmonella is the most common cause of bacterial foodborne outbreaks in the United States. Two outbreaks of Salmonella among nearly 600 inmates and staff in two Arkansas prisons were linked to deficiencies in safe food preparation practices and to eggs produced in the Arkansas correctional system. An investigation conducted by the Arkansas Department of Health (ADH) revealed infections with 15 different pulsed-field gel electrophoresis (PFGE) patterns of Salmonella. To prevent future outbreaks, ADH recommended training in food safety for correctional staff and inmates involved with food preparation, adherence to state guidelines for safe food preparation in prison kitchens, and inspection of prisons by health department staff to ensure staff follow food preparation standards equivalent to commercial food establishments.

3. Two-Dose Varicella Vaccination Coverage among Children Aged 7 years — Six Sentinel Sites, United States, 2006–2012

Substantial progress has been made towards ensuring as many children as possible are protected against varicella. Adoption of two-dose varicella vaccination school entry requirements by more states will help further increase the number of children protected against the disease. In 2007, the Advisory Committee on Immunization Practices (ACIP) recommended a routine second dose of varicella vaccine for children at age 4-6. The number of states with a two-dose varicella vaccine elementary school entry requirement has increased from four in 2007 to 36 in 2012. Two-dose varicella vaccination coverage levels among children aged 7 years in six Immunization Information System sentinel sites increased from a range of 3.6 percent to 8.9 percent in 2006 to a range of 79.9 percent to 92.0 percent in 2012 and are approaching levels of two-dose measles, mumps, rubella (MMR) coverage, which ranged from 81.9 percent to 94.0 percent in 2012. These increases suggest substantial progress in implementing the routine two-dose varicella vaccination program in the 6 years since its recommendation by ACIP.