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1.  Gastroenteritis Outbreak Associated with Unpasteurized Tempeh, North Carolina, USA 
Emerging Infectious Diseases  2013;19(9):1514-1517.
During an investigation of an outbreak of gastroenteritis caused by Salmonella enterica serovar Paratyphi B variant L(+) tartrate(+), we identified unpasteurized tempeh as a novel food vehicle and Rhizopus spp. starter culture as the source of the contamination. Safe handling of uncooked, unpasteurized tempeh should be emphasized for prevention of foodborne illnesses.
doi:10.3201/eid1909.130334
PMCID: PMC3810924  PMID: 23965530
Salmonella enterica serovar Paratyphi B; foodborne illness; soy foods; food handling; tempeh; North Carolina; salmonellosis; enteric infections; gastroenteritis; Salmonella spp.; bacteria
2.  Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program 
BMC Public Health  2012;12:141.
Background
In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders.
Methods
We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data.
Results
Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists.
Conclusions
Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.
doi:10.1186/1471-2458-12-141
PMCID: PMC3337284  PMID: 22361231
3.  Household Responses to School Closure Resulting from Outbreak of Influenza B, North Carolina  
Emerging Infectious Diseases  2008;14(7):1024-1030.
Parents accepted school closure during an outbreak, but children’s presence in other public settings has implications for pandemic planning.
School closure is a proposed strategy for reducing influenza transmission during a pandemic. Few studies have assessed how families respond to closures, or whether other interactions during closure could reduce this strategy’s effect. Questionnaires were administered to 220 households (438 adults and 355 children) with school-age children in a North Carolina county during an influenza B virus outbreak that resulted in school closure. Closure was considered appropriate by 201 (91%) households. No adults missed work to solely provide childcare, and only 22 (10%) households required special childcare arrangements; 2 households incurred additional costs. Eighty-nine percent of children visited at least 1 public location during the closure despite county recommendations to avoid large gatherings. Although behavior and attitudes might differ during a pandemic, these results suggest short-term closure did not cause substantial hardship for parents. Pandemic planning guidance should address the potential for transmission in public areas during school closure.
doi:10.3201/eid1407.080096
PMCID: PMC2600319  PMID: 18598620
Influenza; human; disease outbreaks; schools; research

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