MMWR

Morbidity and Mortality Weekly Report

1. Multistate Outbreak of Human Salmonella Typhimurium Infections Associated with Aquatic Frogs – United States, 2009

Press Contact: CDC Division of Media Relations
(404) 639-3286

Frogs and reptiles, such as turtles, often carry Salmonella that can cause diarrheal illness.  Exposure to aquatic frogs or any material from the frog aquarium, including the water, could cause illness.  Children less than 5 years old are especially vulnerable.  Hands should be thoroughly washed with soap and water after any exposure to frogs or reptiles such as turtles, or their enclosures.  This report summarizes the first known outbreak of Salmonella due to contact with frogs, especially African Dwarf Frogs a type of aquatic frog.  As of December 31, 2009, 85 individuals infected with the outbreak strain of Salmonella were reported from 31 states.  Children have been most affected.  The median age is 5 years and 79 percent of patients are less than 10 years old. Water from a frog aquarium should be considered contaminated.  Aquariums should not be cleaned near food preparation areas such as in the kitchen sink.  CDC recommends washing hands thoroughly with soap and water after touching frogs or reptiles such as turtles, their housing, or anything that comes in contact with their housing, such as water.  Adults should assist young children with hand washing. 

2. Patients Hospitalized with 2009 Pandemic Influenza A (H1N1) – New York City, May 2009

Press Contact: Jessica L. Scaperotti, Press Secretary
New York City Department of Health & Mental Hygiene
(212) 788-5290

Public education campaigns should encourage patients at high risk for severe influenza to get vaccinated and, if infected, to seek treatment for 2009 pandemic influenza A (H1N1) soon after symptom onset. It is important that medical providers offer early antiviral therapy for children under age 2 and to patients with underlying risk conditions.  In spring of 2009, the New York City Department of Health and Mental Hygiene reviewed medical charts of the first 99 patients hospitalized with 2009 pandemic influenza A (H1N1). More than half (59 percent) of these patients were 17 years or younger, and most patients (74 percent) had one or more underlying medical conditions that increase risk of complications from influenza, putting them at greater risk for developing severe illness. Among hospitalized patients, 48 percent had asthma. Additionally, 60 percent of adults and 18 percent of children with recorded height and weight information were obese. Prompt treatment with antiviral medication was associated with shorter average hospital stays (2 days versus 3 days). These and other findings helped to guide control and prevention measures during the outbreak.

3. Outbreak of 2009 Pandemic Influenza A (H1N1) at a School – Hawaii, May 2009

Press Contact: Janice Okubo, Public Information Officer
Hawaii Department of Health
(808) 586-4445

Influenza activity in schools can serve to inform local public health officials of changing disease patterns, especially early in an epidemic; and clear, ongoing communication between education and public health authorities is especially important because guidance on school closures and other policies are updated and revised regularly.  This report summarizes an outbreak representing the first documented community transmission of pandemic H1N1 virus in Hawaii. The Hawaii Department of Health (HDOH) investigated an outbreak of pandemic H1N1 cases at a school on Oahu with a total of 16 cases identified; all patients recovered with no hospitalizations or deaths. HDOH, the school, and the Hawaii Department of Education instituted a campaign asking students and employees to stay home if ill and decided to not close the school. The findings of this investigation contributed to the early understanding of the epidemiology of H1N1 influenza in Hawaii and the role that endemic transmission would play. Influenza activity in schools can serve to inform local public health officials of changing disease patterns, especially early in an epidemic.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES