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2015 ARIZONA INFECTIOUS DISEASE TRAINING & EXERCISE Binational Collaboration Investigating an Outbreak of Vibrio parahaemolyticus Associated with Travel to Puerto Peasco, Sonora, Mexico Catherine Golenko & Mariana Casal- Arizona

  1. 2015 ARIZONA INFECTIOUS DISEASE TRAINING & EXERCISE Binational Collaboration Investigating an Outbreak of Vibrio parahaemolyticus Associated with Travel to Puerto Peñasco, Sonora, Mexico Catherine Golenko & Mariana Casal- Arizona Department of Health Services Healt lth a and W Welln llness f for all ll Arizonans

  2. Vibrio parahaemolyticus Healt lth a and W Welln llness f for all ll Arizonans Photo: Janice Carr Content Providers(s): CDC/ Janice Carr

  3. Photo by: Mik e and dirtyboxfac Healt lth a and W Welln llness f for all ll Arizonans

  4. Photo by Shawn Hoke (CC BY-NC-ND 2.0) Healt lth a and W Welln llness f for all ll Arizonans

  5. Photo by Visualogica (CC BY-NC 2.0) Healt lth a and W Welln llness f for all ll Arizonans

  6. Photo by Bart Everson (CC BY 2.0) Healt lth a and W Welln llness f for all ll Arizonans

  7. 2 Arizona (Pima county) residents with Vibrio parahaemolyticus Healt lth a and W Welln llness f for all ll Arizonans

  8. AZ Case 1: 44 year old female* Rest. A *Symptomatic uncle also Healt lth a and W Welln llness f for all ll Arizonans

  9. AZ Case 2: 46 year old female Rest. A Healt lth a and W Welln llness f for all ll Arizonans

  10. Puerto Peñasco, Sonora, MX Healt lth a and W Welln llness f for all ll Arizonans

  11. Healt lth a and W Welln llness f for all ll Arizonans Photo by Ken Bosma (CC BY 2.0)

  12. Notification to UIEE Sonora, MX SO AZ Healt lth a and W Welln llness f for all ll Arizonans

  13. Sonora update: Foodborne outbreak in progress in Puerto Penasco Rest. A 0 cases Rest. B x cases Rest. C x cases Healt lth a and W Welln llness f for all ll Arizonans Photo by Larry and Ted page (CC BY 2.0)

  14. Arizona updates: Arizona counties, CDC US-MX unit, CDC shellfish unit, and US border health colleagues CDC Quarantine Stations Healt lth a and W Welln llness f for all ll Arizonans

  15. Sonora update: Rest. B 9 Rest. C 1 7 Rest. A Rest. B Rest. C Healt lth a and W Welln llness f for all ll Arizonans

  16. Line list of California residents identified in Sonora Healt lth a and W Welln llness f for all ll Arizonans

  17. Arizona (Maricopa county) identifies 3 rd case of V. parahaemolyticus Healt lth a and W Welln llness f for all ll Arizonans

  18. AZ Case 3: 25 year old male Rest. D *Symptomatic brother also Healt lth a and W Welln llness f for all ll Arizonans

  19. Arizona notifies CDC and Sonora SO update: CDC recommendations: H ealth A lert N etwork NEG Message Healt lth a and W Welln llness f for all ll Arizonans

  20. Arizona notifies US Foodborne colleagues LA County responds … Healt lth a and W Welln llness f for all ll Arizonans

  21. LA County case 1 ?? Healt lth a and W Welln llness f for all ll Arizonans

  22. Arizona sends a HAN 10 Healt lth a and W Welln llness f for all ll Arizonans

  23. No more new cases! Outbreak is over, but still more updates on cases Healt lth a and W Welln llness f for all ll Arizonans

  24. Investigation Highlights 23 cases 10 8 5 Healt lth a and W Welln llness f for all ll Arizonans

  25. Investigation Highlights 23 cases 11 12 Healt lth a and W Welln llness f for all ll Arizonans

  26. Investigation Highlights 23 cases 12 4 7 Healt lth a and W Welln llness f for all ll Arizonans

  27. Binational vibrio parahaemolyticus confirmed and probable cases, by state of residence, 7/28/2014- 8/10/2014 20 Number of cases 15 10 5 0 Date event AZ Confirmed AZ Probable CA confirmed CA probable N=23 SO confirmed SO probable Healt lth a and W Welln llness f for all ll Arizonans

  28. The culprit? 83% Photo by Ilee_wu (CC BY-ND 2.0) Healt lth a and W Welln llness f for all ll Arizonans

  29. 50 % Photo by Farrukh (CC BY-NC 2.0) Healt lth a and W Welln llness f for all ll Arizonans

  30. 83% Photo by Phu Thinh Co (CC BY-SA 2.0) Healt lth a and W Welln llness f for all ll Arizonans

  31. Two months later… Healt lth a and W Welln llness f for all ll Arizonans

  32. Sonora Final Investigation Rest. A Rest. B Rest. C Rest. D CLOSED + + + Healt lth a and W Welln llness f for all ll Arizonans

  33. Sonora Final Investigation POSITIVE for Vibrio NEGATIVE parahaemolyticus Healt lth a and W Welln llness f for all ll Arizonans

  34. Binational Collaboration Healt lth a and W Welln llness f for all ll Arizonans

  35. Language barriers Healt lth a and W Welln llness f for all ll Arizonans Photo by Samuel Abram(CC BY-NC 2.0)

  36. Patient confidentiality Healt lth a and W Welln llness f for all ll Arizonans

  37. Secure and quick information exchange Healt lth a and W Welln llness f for all ll Arizonans Photo by UK Ministry of Defence (CC BY-NC 2.0)

  38. Resources Healt lth a and W Welln llness f for all ll Arizonans Photo by Picture of Money(CC BY 2.0)

  39. Accuracy of information/ quality of information exchange Photo by SparkCBC (CC BY-SA 2.0) and Tex Batmart (CC BY-NC-ND 2.0) Healt lth a and W Welln llness f for all ll Arizonans

  40. Points of contact Healt lth a and W Welln llness f for all ll Arizonans

  41. Prioritization Photo by Jeffrey Beall Healt lth a and W Welln llness f for all ll Arizonans (CC BY-ND 2.0)

  42. Different surveillance methods Photo by Bryan Jones and Allan Foster (CC BY-NC-ND 2.0) Healt lth a and W Welln llness f for all ll Arizonans

  43. Conclusions • Binational outbreaks can be investigated • Follow basic public health measures when you travel • As the old people said “Don’t eat raw seafood  in months without ‘R’” Healt lth a and W Welln llness f for all ll Arizonans

  44. Questions? • Catherine.golenko@azdhs.gov • Mariana. casal@azdhs.gov Healt lth a and W Welln llness f for all ll Arizonans

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