Explore the vast range of titles available.

In February 2001, episodes of acute gastroenteritis were reported to the Wyoming Department of Health from persons who had recently vacationed at a snowmobile lodge in Wyoming. A retrospective cohort study found a significant association between water consumption and illness, and testing identified Norwalk-like virus (NLV) in 8 of 13 stool samples and 1 well. Nucleotide sequences from the positive well-water specimen and 6 of the positive stool samples were identical. This multistrain NLV outbreak investigation illustrates the importance of NLV as a cause of waterborne illness and should encourage monitoring for NLVs in drinking water

A systems approach to environmental health problem solving was used to investigate two waterborne norovirus outbreaks in Wyoming and can serve in the development of improved prevention strategies. An interagency collaboration to prevent waterborne disease involving local, state, and federal partners was designed to coordinate response to outbreak investigations. Improved risk assessment and reporting procedures were also integrated to ensure better availability of necessary data. Public health entities should implement sustainable intersectoral interventions to prevent waterborne disease that not only improve regulatory compliance but also have a positive impact on community health outcomes. Collaborative preventive health and water system protection activities should receive priority attention for implementation in state and local jurisdictions.

Veterinarians are believed to be at increased risk for suicide compared with the general population. Few data on the occurrence of suicidal behavior and suicide risk factors among U.S. veterinarians are available. Veterinarians participating in two wellness summits held during September 2013 concluded that more research is needed on veterinarians and their mental health.

In February 2001, episodes of acute gastroenteritis were reported to the Wyoming Department of Health from persons who had recently vacationed at a snowmobile lodge in Wyoming. A retrospective cohort study found a significant association between water consumption and illness, and testing identified Norwalk-like virus (NLV) in 8 of 13 stool samples and 1 well. Nucleotide sequences from the positive well-water specimen and 6 of the positive stool samples were identical. This multistrain NLV outbreak investigation illustrates the importance of NLV as a cause of waterborne illness and should encourage monitoring for NLVs in drinking water.

Veterinarians are believed to be at increased risk for suicide compared with the general population. Few data on the occurrence of suicidal behavior and suicide risk factors among US veterinarians are available. During Jul 1-Oct 20, 2014, an anonymous, Web-based questionnaire was made available through the Veterinary Information Network, an online community of veterinarians. The questionnaire asked respondents about their experiences with depression and suicidal behavior, and included standardized questions from the Kessler-6 psychological distress scale that assesses for the presence of serious mental illness.

Problem/Condition: A case of occupational asthma is a sentinel health event indicating a need for preventive intervention. Reporting Period Covered: 1988–1992. Description of Systems: As part of the Sentinel Event Notification System for Occupational Risks (SENSOR) Program, initiated by CDC's National Institute for Occupational Safety and Health in 1987, state-based surveillance and intervention programs for occupational asthma (OA) have been under development in Michigan and New Jersey. The initial 5-year projects in these states have been completed. Results: From 1988 through 1992, the SENSOR programs in these states identified a total of 535 cases of occupational asthma and related conditions. Of these 535 cases, 328 cases met the SENSOR surveillance case definition for OA. In addition, 128 cases were classified as possible OA, 42 as reactive airways dysfunction syndrome, and 37 as occupationally aggravated asthma. In both Michigan and New Jersey, manufacturing was the industrial sector with the largest proportion of cases. In Michigan, >40% of the case-patients worked in transportation equipment manufacturing. In New Jersey, 15% of case-patients worked in manufacturing of chemicals and allied products. Overall, isocyanates were the most frequently reported asthma-causing agents (19.4% of cases). Follow-up industrial hygiene sampling measured suspect agents at airborne concentrations generally below the permissible exposure limits established by the Occupational Safety and Health Administration. Interpretation: In its first 5 years, the SENSOR system has led to the identification of previously unrecognized causes of occupational asthma. Overall findings indicate the need for more comprehensive control of such well-known occupational allergens as the isocyanates. In addition, SENSOR interventions have prompted improvements in protection for workers. Actions Taken: Approaches to state-based surveillance and intervention for OA are being developed through newly funded 5-year SENSOR projects in four states (California, Massachusetts, Michigan, and New Jersey). The goal is to develop a model for effective state-based OA surveillance that can be applied by any state health department.

Problem/Condition: Improved surveillance for silicosis is needed to target interventions to prevent this occupational lung disease caused by the inhalation of crystalline silica dust. Reporting Period Covered: 1987—1990. Description of Systems: State-based silicosis surveillance and intervention programs have been developed in Michigan, New Jersey, Ohio, and Wisconsin as part of the Sentinel Event Notification System for Occupational Risks (SENSOR) Program, initiated in 1987 by the National Institute for Occupational Safety and Health (NIOSH). Results: From 1987 through 1990, the SENSOR program confirmed a total of 430 cases of silicosis reported from these four states. Overall, approximately 60% of these cases were in workers employed in primary metal industries, although the types of industries in which cases occurred varied by state. Some cases were attributable to relatively recent exposure, including new cases in seven persons first exposed since 1980 in New Jersey. Silicosis case reports have prompted measurement of respirable silica concentrations at 25 Michigan work sites, and 14 (56%) of these sites were found to have levels that exceeded the legally permissible exposure level. Interpretation: The silicosis surveillance and intervention strategies piloted by state health departments in the NIOSH-funded SENSOR Program have demonstrated the feasibility and effectiveness of identifying specific silica-using work sites that need preventive intervention. Actions Taken: On the basis of initial experience in these four states, NIOSH developed guidelines for state-based silicosis surveillance and awarded SENSOR cooperative agreements to three additional states where the applicability of these surveillance methods will be further evaluated.

Internal oceanic waves are subsurface gravity waves that can be enormous and travel thousands of kilometres before breaking but they are difficult to study; here observations of such waves in the South China Sea reveal their formation mechanism, extreme turbulence, relationship to the Kuroshio Current and energy budget. IWISE catches internal waves mid-ocean Internal waves are the underwater version of more familiar surface waves. They can be enormous and travel thousands of kilometres before breaking. The South China Sea is known to be home to the largest internal waves in the world's oceans, but their size, generation mechanisms and role in the regional energy budget are unknown. Matthew Alford and colleagues now present the results from the IWISE observational campaign and reveal that internal waves more than 200 metres high break in the South China Sea and create turbulence that is orders of magnitude larger than in the open ocean, and that wave formation is influenced by the Kuroshio current. These results now allow for a complete energy budget of the South China Sea, and for a more accurate incorporation of internal waves into climate models. Internal gravity waves, the subsurface analogue of the familiar surface gravity waves that break on beaches, are ubiquitous in the ocean. Because of their strong vertical and horizontal currents, and the turbulent mixing caused by their breaking, they affect a panoply of ocean processes, such as the supply of nutrients for photosynthesis 1 , sediment and pollutant transport 2 and acoustic transmission 3 ; they also pose hazards for man-made structures in the ocean 4 . Generated primarily by the wind and the tides, internal waves can travel thousands of kilometres from their sources before breaking 5 , making it challenging to observe them and to include them in numerical climate models, which are sensitive to their effects 6 , 7 . For over a decade, studies 8 , 9 , 10 , 11 have targeted the South China Sea, where the oceans’ most powerful known internal waves are generated in the Luzon Strait and steepen dramatically as they propagate west. Confusion has persisted regarding their mechanism of generation, variability and energy budget, however, owing to the lack of in situ data from the Luzon Strait, where extreme flow conditions make measurements difficult. Here we use new observations and numerical models to (1) show that the waves begin as sinusoidal disturbances rather than arising from sharp hydraulic phenomena, (2) reveal the existence of >200-metre-high breaking internal waves in the region of generation that give rise to turbulence levels >10,000 times that in the open ocean, (3) determine that the Kuroshio western boundary current noticeably refracts the internal wave field emanating from the Luzon Strait, and (4) demonstrate a factor-of-two agreement between modelled and observed energy fluxes, which allows us to produce an observationally supported energy budget of the region. Together, these findings give a cradle-to-grave picture of internal waves on a basin scale, which will support further improvements of their representation in numerical climate predictions.

Using a combination of models and observations, the US Office of Naval Research Flow Encountering Abrupt Topography (FLEAT) initiative examines how island chains and submerged ridges affect open ocean current systems, from the hundreds of kilometer scale of large current features to the millimeter scale of turbulence. FLEAT focuses on the western Pacific, mainly on equatorial currents that encounter steep topography near the island nation of Palau. Wake eddies and lee waves as small as 1 km were observed to form as these currents flowed around or over the steep topography. The direction and vertical structure of the incident flow varied over tidal, inertial, seasonal, and interannual timescales, with implications for downstream flow. Models incorporated tides and had grids with resolutions of hundreds of meters to enable predictions of flow transformations as waters encountered and passed around Palau's islands. In addition to making scientific advances, FLEAT had a positive impact on the local Palauan community by bringing new technology to explore local waters, expanding the country's scientific infrastructure, maintaining collaborations with Palauan partners, and conducting outreach activities aimed at elementary and high school students, US embassy personnel, and Palauan government officials.