Roshan Reporter

• MD, MPH
• Medical Epidemiologist, Foodborne Diseases at County of Los Angeles Public Health

Worksites with on-site operations have experienced coronavirus disease (COVID-19) outbreaks. We analyzed data for 698 nonresidential, nonhealthcare worksite COVID-19 outbreaks investigated in Los Angeles County, California, USA, during March 19, 2020‒September 30, 2020, by using North American Industry Classification System sectors and subsectors....

Data on the detailed clinical progression of COVID-19 in conjunction with epidemiological and virological characteristics are limited. In this case series, we describe the first 12 US patients confirmed to have COVID-19 from 20 January to 5 February 2020, including 4 patients described previously1,2,3. Respiratory, stool, serum and urine specimens...

Unpasteurized milk can contain harmful bacteria such as Listeria monocytogenes. In 2016, the US Food and Drug Administration notified the Centers for Disease Control and Prevention (Atlanta, GA) that L. monocytogenes isolated from unpasteurized chocolate milk from a Pennsylvania dairy was closely related, by whole-genome sequencing, to L. monocytog...

Reptile contact can result in zoonotic non‐typhoidal salmonellosis. In April 2018, Oregon Public Health Division contacted CDC about a cluster of four Salmonella serovar Fluntern (SF) illnesses in four states (OR, CA, IA, NY); patients reported contact with geckos, a popular reptile pet. PulseNet, the national molecular subtyping network of food‐bo...

Background In 2017, local public health authorities in California received reports of 2 elderly patients with suspected botulism who knew each other socially. A multijurisdictional investigation was conducted to determine the source. Methods Investigators reviewed medical records, interviewed family to establish food and drink histories, and inspe...

The ACDC Program conducted 27 foodborne outbreak investigations this year, most of which were investigated by the Food Safety Unit (96%). Twenty-one of these outbreaks were initiated by FBIR complaints and five FBIRs were initiated through other surveillance activities. Of these 27 investigations, four (15%) were not considered to be foodborne as t...

The ACDC Food Safety Unit conducted 30 outbreak investigations in 2011; 23 were initiated by FBIR complaints and seven were initiated through other surveillance activities. Of these 30 investigations, nine (30%) were not considered to be foodborne as the evidence collected during the investigations did not support a foodborne source (OB#136, 173, 1...

The ACDC Food Safety Unit conducted 20 outbreak investigations this year; 14 were initiated by FBIR complaints and six were initiated through other surveillance activities. Of these 20 investigations, three (15%) where not considered to be foodborne as the evidence collected during the investigations did not support a foodborne source (OB#8, 53 & 1...

The ACDC Food Safety Unit conducted 23 outbreak investigations this year; 18 were initiated by FBIR complaints and five were initiated through other surveillance activities. Of these 23 investigations, five (22%) were not considered to be foodborne upon investigation. All five outbreaks were due to norovirus which can easily be spread person-to-per...

The ACDC Food Safety Unit conducted 31 outbreak investigations this year; 17 were initiated by FBIR complaints and 14 were initiated through other surveillance activities. Of these 31 investigations, 13 (42%) where not considered to be foodborne as the evidence collected during the investigations did not support a foodborne source. Twelve of these...

Of the 31 investigations conducted by ACDC that were suspected to be foodborne in 2007, 30 were conducted by the Food Safety Unit. Of the 31 investigations, 26 were initiated by FBIR complaints and 5 were initiated through other surveillance activities. Ten of the 31 outbreaks were determined to be person-to-person transmission of norovirus in a fo...

In 2006 there were 48 outbreak investigations performed jointly by F&WS and the F&M programs. Twenty-three percent of these investigations (n=11) were caused by person-to-person transmission of norovirus in a food setting and not considered to be food-related. For outbreaks identified as foodborne (n=37), an agent was determined in 95% of outbreaks...

This study reviewed the demographics of persons using web reporting and the impact this method has on the quality of the initial information received from the public.

Objective: Determine the demographics and disease characteristics of cysticercosis cases as well as the trend in cases over time in Los Angeles County.

Zoonotic transmission of Salmonella infections causes an estimated 11% of salmonellosis annually in the United States. This report describes the epidemiologic, traceback and laboratory investigations conducted in the United States as part of four multistate outbreaks of Salmonella infections linked to small turtles. Salmonella isolates indistinguis...

Objective: Turtle-associated salmonellosis (TAS), especially in children, is a reemerging public health issue. In 1975, small pet turtles (shell length <4 inches) sales were banned by federal law; reductions in pediatric TAS followed. Since 2006, the number of multistate TAS outbreaks has increased. We describe 8 multistate outbreaks with illness-...

Listeriosis is a serious foodborne infection that disproportionately affects elderly adults, pregnant women, newborns, and immunocompromised individuals. Diagnosis is made by culturing Listeria monocytogenes from sterile body fluids or products of conception. This report describes investigations of two listeriosis pseudo-outbreaks caused by contami...

BACKGROUND: In October 2013, the Los Angeles County Department of Public Health (LAC-DPH) received a report of several persons ill with diarrhea, vomiting, abdominal cramps, fever, and nausea after attending a fundraising dinner for a private club. METHODS: A partial list of attendees was obtained during the facility inspection conducted by LAC-D...

Background: Shiga toxin-producing Escherichia coli (STEC) are a group of bacterial pathogens that cause severe illness worldwide. Changing epidemiological trends in more recently reported STEC cases in Los Angeles County (LAC) has prompted further study. Method: We examined trends in STEC cases reported to the Department of Public Health (DPH) in L...

BACKGROUND: Los Angeles County (LAC) has had an increase in Shiga toxin-producing Escherichia coli(STEC) reports in recent years, primarily due to an increase in non-O157 serotypes. As a result the workload of the Public Health staff has expanded. LAC compared illness severity, duration, and communicability between O157 STEC and non-O157 STEC cases...

BACKGROUND: The objective of this analysis is to compare the quality of web complaints to those previously only received via telephone. We aim to characterize web based and telephone based complaints by determining the demographics of complainants, the characteristics of the complaints, and evaluate how this new reporting mechanism is impacting the...

Shigellosis is the third most common enteric bacterial infection in the United States (9).…

Author Summary Neurocysticercosis (NCC) is considered one of the major neglected infections of poverty in the United States, with mortality studies indicating that California bears the highest burden of this disease. Although NCC is a reportable disease in California, studies indicate that this disease goes largely under-reported, contributing to t...

Strobe checklist. (PDF)

The objective of this study was to 1) assess the incidence of strongyloidiasis in the United States, 2) evaluate demographic and regional associations, and 3) identify comorbid conditions as risk factors for death. A population-based case-control study was performed by using mortality data during 1991-2006. We identified 347 strongyloidiasis deaths...

Statewide hospital discharge data were used to assess the economic burden of neurocysticercosis in Los Angeles County (LAC) from 1991 through 2008. A neurocysticercosis hospitalization was defined as having a discharge diagnosis of cysticercosis in addition to convulsions, seizures, hydrocephalus, cerebral edema or cerebral cysts. This study identi...

This national outbreak investigation of Salmonella Enteritidis (SE) (PFGE pattern 04) involved considerable coordination and cooperation from federal, state and local entities to identify a source [2]. The outbreak occurred between May 1 and November 30, 2010 and implicated two farms in Iowa with nation-wide product distribution. Through the coordi...

BACKGROUND: Typhoid fever is an acute systemic infectious disease caused by Salmonella typhi which has no non-human reservoir. Recovered cases may become typhoid carriers who may pass the infection to others. Typhoid fever is a reportable disease in California. The Los Angeles County Department of Public Health (LACDPH) follows up on all reported c...

Los Angeles County Department of Public Health (LACDPH) received reports of two clusters of gastroenteritis among patrons of several parties eating at two neighboring restaurants (Restaurants 1 and 2) on November 4th, 2007. Case finding was completed by compiling foodborne illness reports and using available reservation information for the dates in...

BACKGROUND: Cysticercosis is a parasitic infection caused by the larval form of the tapeworm Taenia solium found worldwide. Thirty-two percent of cysticercosis mortality reported nationally (1990-2002, N=221) occurs in Los Angeles County (LAC). METHODS: A review of recently reported LAC cases, as well as trends in reported cases, total hospitaliz...

Background Reptile associated salmonellosis (RAS) has been documented in the US since the 1970's. The Los Angeles County Department of Public Health (LACDPH) received 990 reports of Salmonella infections from persons who had direct or indirect contact with reptiles (i.e. turtles, snakes, lizards) from 1997-2006, representing 9% of all reported salm...

RESULTS: Overall, 990 cases (10%) of salmonellosis reported to LAC DPH were reptile-associated. There was no statistically significant change in the annual incidence rate of RAS cases from 1997 to 2006 (p=0.85) (average 10.7 per 1,000,000: range 7.7-14.1). Turtles, mostly red-eared sliders, were the most commonly reported reptile (overall averag...

Tularemia is a rare, but potentially serious bacterial illness that occurs naturally in California and in Los Angeles County (LAC). A person may develop tularemia after handling infected animal carcasses, exposure to the bite of an infected insect, eating or drinking contaminated food or water, or inhaling the organism. The bacterium that causes tu...

Background: In October, 2004, the Los Angeles County Department of Health Services (LACDHS) investigated a large outbreak of enterotoxigenic Escherichia coli (ETEC) infections following an international religious event. From 1975-2003, only 26 outbreaks of ETEC have been reported in the US. Methods: A case was defined as a person who ate food at th...

Although health departments routinely inspect restaurants to assess compliance with established hygienic standards, few data are available on the effectiveness of these efforts in preventing foodborne disease. The study reported here assessed the impact on foodborne-disease hospitalizations in Los Angeles County of a restaurant hygiene grading syst...

In 2000, shigellosis traced to a commercially prepared dip developed in 406 persons nationwide. An ill employee may have inadvertently contaminated processing equipment. This outbreak demonstrates the vulnerability of the food supply and how infectious organisms can rapidly disseminate through point-source contamination of a widely distributed food...

Background: Salmonella is a frequent cause of foodborne illness in the United States. Trends in Salmonella incidence, hospitalization rates and outbreak etiologies in Los Angeles County from 1992-2001 are described. Methods: Routine case history data is collected on passively reported cases of salmonellosis. Hospital discharge data was obtained fro...

Norway rats (Rattus norvegicus) are hosts for various microbes. Homeless people who have contact with rats may be at risk of infection by them. The Los Angeles County Department of Health Services initiated a seroepidemiologic study among patients who used a free clinic in downtown Los Angeles; 200 serum specimens obtained for other routine assays...

While evaluating quinolone resistance in a sample of Campylobacter isolates recovered from patients with campylobacteriosis in Los Angeles County, California, in 1998, we discovered that the second most frequently isolated species was Campylobacter upsaliensis (6 [4%] of 155 isolates). The ability of laboratories to recover this species may be depe...

An outbreak of Salmonella serotype Thompson in California was identified through laboratory-based surveillance and investigated with case-control, traceback, and laboratory studies. There were 35 “sporadic” cases and a restaurant-associated outbreak of 41 cases with onset between 6 March and 31 March 1999. Three case patients were hospitalized. A c...

Ceftriaxone, an expanded-spectrum cephalosporin, is an antimicrobial agent commonly used to treat severe Salmonella infections, especially in children. Ceftriaxone-resistant Salmonella infections have recently been reported in the United States, but the extent of the problem is unknown. To summarize national surveillance data for ceftriaxone-resist...

An outbreak of Salmonella serogroup Saphra (S. saphra) infections was studied by laboratory-based surveillance, case-control and trace-back studies, and a survey of cantaloupe preparation practices. Twenty-four patients with S. saphra infections had illness onsets between 23 February and 15 May 1997; 75% were ⩽6 years old; 23% were hospitalized. Ca...

Background: Endemic typhus fever (ET) or flea-borne typhus is commonly associated with foreign travel. Proximity of homes to semi-wilderness areas in the southwestern United States creates environments which allow disease transmission. We describe Los Angeles County (LAC) ET cases, their geographic environment, domestic and wild animal exposures an...

Salmonella saphra infections are rarely reported; to our knowledge, no outbreak due to this serotype has ever been investigated. Between 2/23 and 4/23/97, 23 cases were reported in California (vs. 3 in all of 19%). Of 13 isolates tested, all had identical pulsed field gel electrophoresis patterns. We interviewed all case-patients and, to determine...

Between April and July 1994, 501 cases of Salmonella enteritidis infection were reported in Los Angeles County, California, nearly 5 times the number reported between April and July 1993; of these, 422 (84%) were sporadic (not related to known outbreaks). A case-control study was done to determine risk factors for sporadic illness; the distribution...

From January through March 1993, there were 54 cases of meningococcal disease in Los Angeles County, California, of which 9 occurred among men incarcerated in the county's jail system, which was 40 percent above capacity at the time. Several of the 45 patients from the community had had contact with men recently released from a county jail. We inte...

When seven immunocompromised patients developed invasive aspergillosis during construction at a hospital, new methods were performed to compare fungal isolates and a case-control study was conducted to determine risks for infection. Typing of Aspergillus flavus with the use of restriction endonuclease analysis and restriction fragment length polymo...

When seven immunocompromised pateints developed invasive aspergillosis during construction at a hospital, new methods were performed to compare fungal isolates and a ease-control study was conducted to determine risks for infection. Typing of Aspergillus flavus with the use of restriction endonuclease analysis and restriction fragment length polymo...