Retrospective evaluation of an integrated molecular-epidemiological approach to cyclosporiasis outbreak investigations - United States, 2021.

Ahart, L; Jacobson, D; Rice, M; Richins, T; Peterson, A; Zheng, Y; Barratt, J; Cama, V; Qvarnstrom, Y; Montgomery, S; Straily, A

Retrospective evaluation of an integrated molecular-epidemiological approach to cyclosporiasis outbreak investigations - United States, 2021.

Ahart, L Jacobson, D Rice, M Richins, T Peterson, A Zheng, Y Barratt, J

Cama, V Qvarnstrom, Y Montgomery, S Straily, A

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Publisher:: Cambridge University Press (CUP)
Publication Type:: Journal Article
Citation:: Epidemiol Infect, 2023, 151, pp. e131
Issue Date:: 2023-07-19

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Field	Value	Language
dc.contributor.author	Ahart, L
dc.contributor.author	Jacobson, D
dc.contributor.author	Rice, M
dc.contributor.author	Richins, T
dc.contributor.author	Peterson, A
dc.contributor.author	Zheng, Y
dc.contributor.author	Barratt, J https://orcid.org/0000-0001-8711-2408
dc.contributor.author	Cama, V
dc.contributor.author	Qvarnstrom, Y
dc.contributor.author	Montgomery, S
dc.contributor.author	Straily, A
dc.date.accessioned	2024-02-06T04:05:52Z
dc.date.available	2024-02-06T04:05:52Z
dc.date.issued	2023-07-19
dc.identifier.citation	Epidemiol Infect, 2023, 151, pp. e131
dc.identifier.issn	0950-2688
dc.identifier.issn	1469-4409
dc.identifier.uri	http://hdl.handle.net/10453/175359
dc.description.abstract	Cyclosporiasis results from an infection of the small intestine by Cyclospora parasites after ingestion of contaminated food or water, often leading to gastrointestinal distress. Recent developments in temporally linking genetically related Cyclospora isolates demonstrated effectiveness in supporting epidemiological investigations. We used 'temporal-genetic clusters' (TGCs) to investigate reported cyclosporiasis cases in the United States during the 2021 peak-period (1 May - 31 August 2021). Our approach split 655 genotyped isolates into 55 genetic clusters and 31 TGCs. We linked two large multi-state epidemiological clusters (Epidemiologic Cluster 1 [n = 136 cases, 54 genotyped] and Epidemiologic Cluster 2 [n = 42 cases, 15 genotyped]) to consumption of lettuce varieties; however, product traceback did not identify a specific product for either cluster due to the lack of detailed product information. To evaluate the utility of TGCs, we performed a retrospective case study comparing investigation outcomes of outbreaks first detected using epidemiological methods with those of the same outbreaks had TGCs been used to first detect them. Our study results indicate that adjustments to routine epidemiological approaches could link additional cases to epidemiological clusters of cyclosporiasis. Overall, we show that CDC's integrated genotyping and epidemiological investigations provide valuable insights into cyclosporiasis outbreaks in the United States.
dc.format	Electronic
dc.language	eng
dc.publisher	Cambridge University Press (CUP)
dc.relation.ispartof	Epidemiol Infect
dc.relation.isbasedon	10.1017/S0950268823001176
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Epidemiology
dc.subject.classification	3009 Veterinary sciences
dc.subject.classification	3202 Clinical sciences
dc.subject.classification	4202 Epidemiology
dc.subject.mesh	Humans
dc.subject.mesh	Cyclosporiasis
dc.subject.mesh	Cyclospora
dc.subject.mesh	Disease Outbreaks
dc.subject.mesh	Molecular Epidemiology
dc.subject.mesh	United States
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Feces
dc.subject.mesh	Feces
dc.subject.mesh	Humans
dc.subject.mesh	Cyclospora
dc.subject.mesh	Cyclosporiasis
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Disease Outbreaks
dc.subject.mesh	United States
dc.subject.mesh	Molecular Epidemiology
dc.subject.mesh	Humans
dc.subject.mesh	Cyclosporiasis
dc.subject.mesh	Cyclospora
dc.subject.mesh	Disease Outbreaks
dc.subject.mesh	Molecular Epidemiology
dc.subject.mesh	United States
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Feces
dc.title	Retrospective evaluation of an integrated molecular-epidemiological approach to cyclosporiasis outbreak investigations - United States, 2021.
dc.type	Journal Article
utslib.citation.volume	151
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Science
pubs.organisational-group	University of Technology Sydney/Faculty of Science/School of Life Sciences
utslib.copyright.status	open_access	*
dc.date.updated	2024-02-06T04:05:51Z
pubs.publication-status	Published online
pubs.volume	151

Abstract:

Cyclosporiasis results from an infection of the small intestine by Cyclospora parasites after ingestion of contaminated food or water, often leading to gastrointestinal distress. Recent developments in temporally linking genetically related Cyclospora isolates demonstrated effectiveness in supporting epidemiological investigations. We used 'temporal-genetic clusters' (TGCs) to investigate reported cyclosporiasis cases in the United States during the 2021 peak-period (1 May - 31 August 2021). Our approach split 655 genotyped isolates into 55 genetic clusters and 31 TGCs. We linked two large multi-state epidemiological clusters (Epidemiologic Cluster 1 [n = 136 cases, 54 genotyped] and Epidemiologic Cluster 2 [n = 42 cases, 15 genotyped]) to consumption of lettuce varieties; however, product traceback did not identify a specific product for either cluster due to the lack of detailed product information. To evaluate the utility of TGCs, we performed a retrospective case study comparing investigation outcomes of outbreaks first detected using epidemiological methods with those of the same outbreaks had TGCs been used to first detect them. Our study results indicate that adjustments to routine epidemiological approaches could link additional cases to epidemiological clusters of cyclosporiasis. Overall, we show that CDC's integrated genotyping and epidemiological investigations provide valuable insights into cyclosporiasis outbreaks in the United States.

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http://hdl.handle.net/10453/175359