MMWR News Synopsis for Friday, February 22, 2019

Campylobacteriosis Outbreak Associated with Contaminated Municipal Water Supply — Nebraska, 2017

Polly Carver-Kimm
Communications Director
Iowa Department of Public Health
515-281-6693 (24/7)
Polly.Carver-Kimm@idph.iowa.gov

Public health professionals should consider the potential role that wastewater near older, shallow wells serving municipal water systems can play in Campylobacter outbreaks. We describe an event in Nebraska involving the malfunction of a center pivot irrigation system intended to pump livestock wastewater from a nearby concentrated animal feeding operation (CAFO) onto adjacent farm land.. This allowed excessive run-off to collect in a road ditch near two wells that fed a municipal water supply, sickening 39 people who consumed the untreated city water. The use of culture-independent diagnostic tests (CIDTs) was important in this outbreak. Had this technology not been recently implemented in rural Nebraska hospitals, the outbreak might have gone undetected. The use of CIDTs facilitated early and comprehensive case identification allowing for rapid public health intervention and response. This incident also shows that exposure to cattle waste is an important potential risk for Campylobacter outbreaks in the United States.

Public Health Emergency Risk Communication and Social Media Reactions to an Errant Warning of a Ballistic Missile Threat — Hawaii, January 2018

CDC Media Relations
404-639-3286

Our findings suggest that public health agencies can harness social media to convey public health messages that are accurate, actionable, timely, and credible to help save lives during an unfolding crisis. When disasters strike, people want answers. During the false ballistic missile alert in Hawaii in January 2018, people who believed they were in danger turned to Twitter to seek information. Our qualitative analysis found that during the immediate aftermath of the threat, information processing, information sharing, authentication, and emotional reactions were the major themes on Twitter. After the erroneous warning was withdrawn, we identified denunciation, insufficient knowledge to act, and mistrust of authority as social-media themes. Our findings emphasize that, during a public health emergency, public health agencies should acknowledge and address emotional reactions and account for how people interpret, share, and react to public health messaging to ensure that the right message is sent at the right time.

Leveraging Existing Birth Defects Surveillance Infrastructure to Build Neonatal Abstinence Syndrome Surveillance Systems — Illinois, New Mexico, and Vermont, 2015–2016

CDC Media Relations
404-639-3286

Neonatal abstinence syndrome (NAS) surveillance based solely on diagnosis codes in hospital records, without confirmation, might slightly overestimate the number of babies born with NAS. Neonatal abstinence syndrome (NAS) is a withdrawal syndrome that can occur in newborns exposed to certain substances, such as opioids, during pregnancy. This report builds on existing birth defects surveillance infrastructure in Illinois, New Mexico, and Vermont to estimate the number of babies born with NAS and to confirm the diagnosis through medical record review. Researchers also looked at how well codes in hospital records correctly identified babies with confirmed NAS. In 2015, estimates of confirmed NAS in Illinois, New Mexico, and Vermont were 3.0, 7.5, and 30.8 per 1,000 births, respectively. The wide variation might be due to differences in efforts to diagnose and treat NAS in newborns and opioid use disorder in mothers. Of the codes reviewed, those for infant drug withdrawal had the highest likelihood of correctly identifying babies with confirmed NAS. The methods used in this project might help inform other states’ efforts to estimate NAS.

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CDC works 24/7 protecting America’s health, safety, and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, stem from human error or deliberate attack, CDC is committed to respond to America’s most pressing health challenges.

Page last reviewed: February 20, 2019