BACKGROUND:Travelers who fly on commercial aircraft while infectious with measles are reported to the US Centers for Disease Control and Prevention (CDC) by health departments. CDC contacts airlines to collect information on potentially exposed travelers. Traveler locating information is shared with health departments to facilitate aircraft contact investigations. In May 2025, CDC was notified of a traveler who flew from Europe to Colorado while infectious with measles, transited through Denver International Airport, then flew from Colorado to North Dakota. This report describes details of the subsequent contact investigations, environmental assessment, and laboratory testing results. METHODS:CDC laboratories conducted testing on a majority of case samples. Data from the CDC laboratory, CDC's Port Health Activity Reporting System, and health department investigations were analyzed to describe the index case, contacts, test results, and travel details. Flight records and visual inspection were used to describe relative locations of index and secondary case-patients at Denver International Airport. RESULTS:The index case was in an unvaccinated adult. Aircraft contact investigations identified 135 exposed domestic travelers. Fifteen secondary cases were identified among people exposed during the international (5) and domestic (3) flights and at the airport (7). Two tertiary case-patients were also identified. Five of the secondary case-patients had at least 1 documented prior measles vaccination. CONCLUSIONS:Measles transmission may occur during travel. Measles vaccination is recommended prior to international travel for all travelers aged 6 months or older. Travelers with fever and other overt signs of transmissible illness, such as coughing or malaise, should be strongly encouraged to delay travel while symptomatic.
Abstract Background Understanding the risk factors of hypertension among women of reproductive age (18–44 years) is important for guiding health programs aimed at reducing the burden of hypertensive disorders in this population. Therefore, the objective of this study was to investigate predictors of self-reported hypertension among women of reproductive age in North Dakota. Methods Behavioral Risk Factor Surveillance System data for the years 2017, 2019, and 2021 were obtained from North Dakota Department of Health and Human Services. A conceptual model was used to identify potential predictors of hypertension including sociodemographic characteristics, behavioral factors, chronic health conditions, and healthcare access. A multivariable binary logistic regression model was then used to identify significant predictors of hypertension. The predictive ability of the final model was assessed using a Receiver Operating Characteristic (ROC) curve and area under the curve (AUC). Results The odds of hypertension were significantly higher among women of reproductive age who reported frequent mental distress (odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.3–3.3), resided in a primary care health professional shortage area (OR = 1.8, 95% CI = 1.2–2.6), were obese (OR = 2.6, 95% CI = 1.7–4.1) and were 35–44 years old (OR = 2.3, 95% CI = 1.6–3.4), relative to their counterparts who did not have frequent mental distress, did not reside in a health professional shortage area, had a normal body mass index, and were 18–34 years old, respectively. Additionally, the odds of hypertension were lower among women who did not have a checkup within the last year compared to those who did have a checkup within the last year (OR = 0.6, 95% CI = 0.4–0.9). The AUC of the final model was 0.68. Conclusions There is evidence that frequent mental distress and disparities in healthcare access or utilization are predictors of hypertension among women of reproductive age in North Dakota. Further research is warranted to determine whether improved mental health can reduce the risk of hypertension in this population. Public health officials may consider promoting hypertension awareness and control programs in areas with limited access to healthcare professionals.
BackgroundShedding of Salmonella is not unusual in captive exotic animals; however, few cases link Salmonella to chronic disease or death of exotic felids.Case SummaryWe report a multidrug-resistant (MDR) Salmonella enterica serovar Newport, persisting strain REPJJP01, isolated from exotic felids from two separate regional zoos and potentially contributing to the death of a snow leopard (Panthera uncia) and a Pallas’s cat (Otocolobus manul). REPJJP01 strains of S. Newport are a recurring cause of human enteric disease outbreaks associated with travel to Mexico and beef products.ConclusionThis case highlights the value of genotypic and phenotypic techniques to identify shared and potentially MDR strains of Salmonella from human and animal hosts. Importantly, these cases expand the host range of S. Newport persisting strain REPJJP01.
Background To characterize neurodevelopmental abnormalities in children up to 36 months of age with congenital Zika virus exposure. Methods From the U.S. Zika Pregnancy and Infant Registry, a national surveillance system to monitor pregnancies with laboratory evidence of Zika virus infection, pregnancy outcomes and presence of Zika associated birth defects (ZBD) were reported among infants with available information. Neurologic sequelae and developmental delay were reported among children with ≥1 follow-up exam after 14 days of age or with ≥1 visit with development reported, respectively. Results Among 2248 infants, 10.1% were born preterm, and 10.5% were small-for-gestational age. Overall, 122 (5.4%) had any ZBD; 91.8% of infants had brain abnormalities or microcephaly, 23.0% had eye abnormalities, and 14.8% had both. Of 1881 children ≥1 follow-up exam reported, neurologic sequelae were more common among children with ZBD (44.6%) vs. without ZBD (1.5%). Of children with ≥1 visit with development reported, 46.8% (51/109) of children with ZBD and 7.4% (129/1739) of children without ZBD had confirmed or possible developmental delay. Conclusion Understanding the prevalence of developmental delays and healthcare needs of children with congenital Zika virus exposure can inform health systems and planning to ensure services are available for affected families. Impact We characterize pregnancy and infant outcomes and describe neurodevelopmental abnormalities up to 36 months of age by presence of Zika associated birth defects (ZBD). Neurologic sequelae and developmental delays were common among children with ZBD. Children with ZBD had increased frequency of neurologic sequelae and developmental delay compared to children without ZBD. Longitudinal follow-up of infants with Zika virus exposure in utero is important to characterize neurodevelopmental delay not apparent in early infancy, but logistically challenging in surveillance models.
CONTEXT:Public health professionals around the country faced significant challenges responding to the COVID-19 pandemic. Reflecting on their experience is an essential element in making sense of their experience and learning from it.OBJECTIVE:The objective of this qualitative study was to (1) describe the lived experiences of public health professionals working during the COVID-19 pandemic, (2) discuss the effectiveness of a guided reflection exercise to help public health professionals process these experiences, and (3) provide lessons learned and best practices to inform preparation for a future infectious disease pandemic.DESIGN:Qualitative focus group study design.SETTING:This activity was conducted at a Midwestern state public health professional meeting.PARTICIPANTS:Forty-eight public health professionals self-selected to participate in this study.RESULTS:Five themes were elicited in this analysis, including Communication, Leadership and Collaboration, Data Management, Community Relationships, and Resources and Planning. In addition, public health professionals reported numerous lessons learned, including the need for more leadership from the state government, the conflicted response of their communities, and the benefits of community solidarity where it was present.CONCLUSIONS:This article provides a detailed account of public health workers' experiences during the COVID-19 pandemic. It also provides lessons learned that will help public health workers lead more effectively in the future. Guided reflection on a traumatic professional experience can assist participating individuals in making sense of their experience and learning important lessons from it.
