Dupage County Health Department

BackgroundOutbreaks of coronavirus disease 2019 (COVID-19) have been reported in nursing homes and assisted living facilities; however, the extent of asymptomatic and presymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in this high-risk population remains unclear.MethodsWe conducted an investigation of the first known outbreak of SARS-CoV-2 at a skilled nursing facility (SNF) in Illinois on 15 March 2020 and followed residents for 30 days. We tested 126/127 residents for SARS-CoV-2 via reverse-transcription polymerase chain reaction and performed symptom assessments. We calculated the point prevalence of SARS-CoV-2 and assessed symptom onset over 30-day follow-up to determine: (1) the proportion of cases who were symptomatic, presymptomatic, and asymptomatic and (2) incidence of symptoms among those who tested negative. We used the Kaplan-Meier method to determine the 30-day probability of death for cases.ResultsOf 126 residents tested, 33 had confirmed SARS-CoV-2 on 15 March. Nineteen (58%) had symptoms at the time of testing, 1 (3%) developed symptoms over follow-up, and 13 (39%) remained asymptomatic. Thirty-five residents who tested negative on 15 March developed symptoms over follow-up; of these, 3 were re-tested and 2 were positive. The 30-day probability of death among cases was 29%.ConclusionsSNFs are particularly vulnerable to SARS-CoV-2, and residents are at risk of severe outcomes. Attention must be paid to preventing outbreaks in these and other congregate care settings. Widespread testing and infection control are key to help prevent COVID-19 morbidity and mortality in these high-risk populations.

BackgroundIn 2016, Candida auris was first reported in the United States, with 2 Illinois patients among the first cases. In response, the state and 3 Chicago-area health departments (HDs) investigated clinical cases and performed point prevalence surveys (PPSs) to identify colonized cases.MethodsClinical cases had positive C. auris cultures obtained for clinical care; colonized cases had positive surveillance cultures during PPSs. In August 2016–January 2018, PPSs were performed in Chicago-area acute care hospital (ACH) intensive care units, long-term acute-care hospitals (LTACHs), and high-acuity floors of skilled nursing facilities (SNFs) and SNFs caring for ventilated patients (vSNFs). Facility and HD staff obtained composite axilla/groin swabs from assenting patients to detect colonization. Facilities with an epidemiologic link to a clinical case or a shared patient population with a facility housing a clinical case were prioritized for PPSs.ResultsDuring May 2016–January 2018, Chicago-area facilities reported 24 clinical cases, including 10 bloodstream infections. HDs performed 33 PPSs at 20 facilities (5 ACHs, 5 LTACHs, 3 SNFs, and 7 vSNFs) during August 2016–January 2018. Of 1,364 patients screened, 92 (6.7%) were colonized with C. auris; 10 (50%) facilities had ≥1 colonized patient. A significantly higher proportion screened positive from September 2017 to January 2018 (84/822, 10.2%) than in August 2016–August 2017 (8/542, 1.5%; z-test P < 0.01). Prevalence of C. auris colonization was highest in vSNFs (median: 7.7%; range: 0%–43.3%), compared with ACHs (0%; 0%–6.3%), LTACHs (0%; 0%–14.3%), and SNFs (0%, 0%–1.5%). PPSs in vSNFs identified 91% (84/92) of colonized cases. Among 5 vSNFs with repeat PPSs, 4 had higher prevalence on repeat screening (median: 26.1%; range: 0%–43.3%) than at baseline (1.2%; 0%–17.0%).ConclusionC. auris has rapidly emerged in the Chicago area. Increasing prevalence of C. auris colonization during repeat PPSs indicates transmission and amplification within vSNFs. To prevent spread, state and local HDs provided infection control recommendations, disseminated health alerts, and recommended placing vSNF patients from high-acuity floors on transmission-based precautions.DisclosuresAll authors: No reported disclosures.

Abstract Multi‐species approaches provide valuable insight for conservation planning, yet most studies focus on only one species while generalizing across taxa. Here, we employed 5–14 microsatellite DNA loci to evaluate population genetic patterns and future vulnerability for a freshwater turtle assemblage distributed across north‐eastern Illinois. Focal species (Emydoidea blandingii, Clemmys guttata, Chrysemys picta and Chelydra serpentina) differ in conservation status as well as in ecological and life‐history traits, which modulate gene flow across heterogeneous landscapes. We hypothesized (1) common and more ubiquitous species (C. picta and C. serpentina) would exhibit higher levels of genetic connectivity compared to species more restricted in distributions and with an elevated conservation status (E. blandingii and C. guttata) and (2) endangered species exhibit a greater loss of future genetic diversity. We found that genetic patterns varied considerably among co‐distributed species. Endangered species had lower levels of genetic diversity and gene flow, more pronounced genetic structure and a higher risk of genetic drift compared to common species, thus supporting our hypotheses. The observed patterns are potentially attributable to life‐history and ecological traits and will affect the long‐term viability of the four species within a modified north‐eastern Illinois landscape. Our study is an important first step for understanding how landscape features and species‐specific traits interact to affect gene flow and population genetic structure within altered landscapes. It also underscores how multi‐species approaches can be informative for conservation actions.

Project objective is to improve the District's alternative fueling infrastructure by installing storage tanks and dispensers for E-85 and Bio-Diesel at the existing Blackwell Forest Preserve Alternative Fuel Station. The addition of E-85 and Bio-Diesel at this station will continue to reduce our dependency on foreign oil, while promoting the use of clean burning, domestically produced, renewable alternative fuels. In addition, this station will promote strong intergovernmental cooperation as other governmental agencies have expressed interest in utilizing this station.

Traditional instructional environments for at-risk (i.e., unmotivated) students are teacher controlled and provide low-level, routine tasks. This, however, contradicts current theory and research regarding environments that enhance motivation to learn. To effectively assist motivationally disadvantaged students, instructional environments must support autonomy and challenge. Six “at-risk” students in an alternative education program completed motivation surveys after engaging in various learning activities. Overall, the participants completed 54 surveys. Using multiple regression, involvement, boredom, confusion, competence, and desire to be doing something else were regressed on perceived challenge and perceived control. The results indicated that control and challenge were significant predictors of the motivation variables. The findings are discussed in terms of awakening to the powerful influence of instructional tasks on student motivation and desire to engage in learning activities. Limitations of the present study provide insights into future endeavors. © 1999 John Wiley & Sons, Inc.

(1999). Using the Wizard of Oz to Teach Students about Healthy and Unhealthy Relationships. Journal of Health Education: Vol. 30, No. 1, pp. 51-59.

ABSTRACT:Special district structure in US metropolitan areas has not been analyzed, although studies document the growth of special districts and their impact on the coordination and planning activities of local governments. Few estimates have been made of public capital spending in metropolitan areas and none that classify spending by cities and special districts. Thus, there has been no comparison of how metropolitan areas differ in their reliance on special districts. This paper attempts to fill these research voids. The authors studied the 1987 capital spending patterns of 105 metropolitan areas. While the outlays for special districts were significant, city governments were the major force in infrastructure capital spending. Although metropolitan regions with high reliance on special districts had higher incomes, private capital investment was slightly higher. The authors found no evidence that reliance on special districts was associated with higher levels of outstanding debt.

Two venlafaxine (Effexor)-related deaths are reported with comparison of results from the analysis of specimens using capillary gas chromatography with a nitrogen-phosphorous detector (GC-NPD) and high-performance liquid chromatography (HPLC) using a UV-vis detector. Blood concentrations in Case 1 were 7.27 micrograms/mL venlafaxine and 5.03 micrograms/mL O-desmethylvenlafaxine, and Case 2 had 89.67 micrograms/mL venlafaxine with 3.44 micrograms/mL of the desmethyl metabolite. A comparison of analytical methods and specimen concentration is presented.

Employees of a large suburban health care center were asked to identify their needs and preferences for child care, and existing fringe benefits that they would be willing to give up in order to obtain employer supported child care services. Results indicate that a majority of the 41 employees in the sample with children under 12 years of age experience problems relating to child care and that those problems affect their work performance. There is no clear preference for type of child care, however, and employees are unwilling to give up existing fringe benefits to obtain child care services. Results are discussed with implications for provision of employer supported child care that is sensitive to the individual needs of employees.