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Concept: Michigan


Coinciding with major changes to its municipal water system, Flint, MI, endured Legionnaires' disease outbreaks in 2014 and 2015. By sampling premise plumbing in Flint in the fall of 2016, we found that 12% of homes harbored legionellae, a frequency similar to that in residences in neighboring areas. To evaluate the genetic diversity of Legionella pneumophila in Southeast Michigan, we determined the sequence type (ST) and serogroup (SG) of the 18 residential isolates from Flint and Detroit, MI, and the 33 clinical isolates submitted by hospitals in three area counties in 2013 to 2016. Common to one environmental and four clinical samples were strains of L. pneumophila SG1 and ST1, the most prevalent ST worldwide. Among the Flint premise plumbing isolates, 14 of 16 strains were of ST367 and ST461, two closely related SG6 strain types isolated previously from patients and corresponding environmental samples. Each of the representative SG1 clinical strains and SG6 environmental isolates from Southeast Michigan infected and survived within macrophage cultures at least as well as a virulent laboratory strain, as judged by microscopy and by enumerating CFU. Likewise, 72 h after infection, the yield of viable-cell counts increased >100-fold for each of the representative SG1 clinical isolates, Flint premise plumbing SG6 ST367 and -461 isolates, and two Detroit residential isolates. We verified by immunostaining that SG1-specific antibody does not cross-react with the SG6 L. pneumophila environmental strains. Because the widely used urinary antigen diagnostic test does not readily detect non-SG1 L. pneumophila, Legionnaires' disease caused by SG6 L. pneumophila is likely underreported worldwide.IMPORTANCEL. pneumophila is the leading cause of disease outbreaks associated with drinking water in the United States. Compared to what is known of the established risks of colonization within hospitals and hotels, relatively little is known about residential exposure to L. pneumophila One year after two outbreaks of Legionnaires' disease in Genesee County, MI, that coincided with damage to the Flint municipal water system, our multidisciplinary team launched an environmental surveillance and laboratory research campaign aimed at informing risk management strategies to provide safe public water supplies. The most prevalent L. pneumophila strains isolated from residential plumbing were closely related strains of SG6. In laboratory tests of virulence, the SG6 environmental isolates resembled SG1 clinical strains, yet they are not readily detected by the common diagnostic urinary antigen test, which is specific for SG1. Therefore, our study complements the existing epidemiological literature indicating that Legionnaires' disease due to non-SG1 strains is underreported around the globe.

Concepts: Epidemiology, Water, Legionellosis, Legionella, Drinking water, Infrastructure, Michigan, Water supply network


Although there is great enthusiasm in both the public and private sector for the further development and use of large-scale consumer-facing public health applications for mobile platforms, little is known about user experience and satisfaction with this type of approach. As a part of the Beacon Community Cooperative Agreement Program, txt4health, a public-facing, mobile phone-based health information service targeting type 2 diabetes, was launched in 3 Beacon Communities: the Southeast Michigan Beacon Community in Detroit, MI, the Greater Cincinnati Beacon Community in Cincinnati, OH, and the Crescent City Beacon Community in New Orleans, LA. This program was marketed via large public health campaigns and drew many users within the respective communities.

Concepts: Health care, Diabetes mellitus type 2, Louisiana, Text messaging, Michigan, New Orleans, National Football League, Amtrak


There are an estimated 25.8 million American children and adults, equivalent to 8.3% of the US population, living with diabetes. Diabetes is particularly burdensome on minority populations. The use of mobile technologies for reaching broad populations is a promising approach, given its wide footprint and ability to deliver inexpensive personalized messages, to increase awareness of type 2 diabetes and promote behavior changes targeting risk factors associated with type 2 diabetes. As a part of the Beacon Community Cooperative Agreement Program, txt4health, a public-facing mobile health information service, was launched in 3 Beacon Communities: the Southeast Michigan Beacon Community in Detroit, MI, the Greater Cincinnati Beacon Community in Cincinnati, OH, and the Crescent City Beacon Community in New Orleans, LA. Txt4health is a mobile health information service designed to help people understand their risk for type 2 diabetes and become more informed about the steps they can take to lead healthy lives.

Concepts: Health care, Nutrition, Diabetes mellitus type 2, Louisiana, Text messaging, Michigan, New Orleans, Amtrak


Strong evidence indicates that highly repetitive manual work is associated with the development of upper extremity musculoskeletal disorders (MSDs). One of the occupational activities that involves highly repetitive and forceful hand work is manual pipetting in chemical or biological laboratories. In the current study, we quantified tendon displacement as a parameter to assess the cumulative loading exposure of the musculoskeletal system in the thumb during pipetting. The maximal tendon displacement was found in the flexor pollicis longus (FPL) tendon. Assuming that subjects' pipetting rates were maintained constant during a period of 1h, the average accumulated tendon displacement in the FPL reached 29m, which is in the lower range of those observed in other occupational activities, such as typing and nail gun operations. Our results showed that tendon displacement data contain relatively small standard deviations, despite high variances in thumb kinematics, suggesting that the tendon displacements may be useful in evaluating the musculoskeletal loading profile.

Concepts: Variance, Standard deviation, Flexor pollicis longus muscle, Extensor pollicis brevis muscle, Michigan, Musculoskeletal system


On August 3, 2016, the Ohio Department of Health Laboratory reported to CDC that a respiratory specimen collected on July 28 from a male aged 13 years who attended an agricultural fair in Ohio during July 22-29, 2016, and subsequently developed a respiratory illness, tested positive by real-time reverse transcription-polymerase chain reaction (rRT-PCR) for influenza A(H3N2) variant* (H3N2v). The respiratory specimen was collected as part of routine influenza surveillance activities. The next day, CDC was notified of a child aged 9 years who was a swine exhibitor at an agricultural fair in Michigan who became ill on July 29, 2016, and tested positive for H3N2v virus at the Michigan Department of Health and Human Services Laboratory. Investigations by Michigan and Ohio health authorities identified 18 human infections linked to swine exhibits at agricultural fairs. To minimize transmission of influenza viruses from infected swine to visitors, agricultural fair organizers should consider prevention measures such as shortening the time swine are on the fairgrounds, isolating ill swine, maintaining a veterinarian on call, providing handwashing stations, and prohibiting food and beverages in animal barns. Persons at high risk for influenza-associated complications should be discouraged from entering swine barns.

Concepts: Human, Virus, Infection, Illness, Influenza, Transmission and infection of H5N1, Michigan, Computer virus


In Flint; MI; USA; a public health crisis resulted from the switching of the water supply from Lake Huron to a more corrosive source from the Flint River in April 2014; which caused lead to leach from water lines. Between 2010 and 2015; Flint area children’s average blood lead patterns display consistent peaks in the third quarter of the year. The third quarter blood lead peaks displayed a declining trend between 2010 and 2013; then rose abruptly between the third quarters of 2013 from 3.6% blood lead levels ≥5 µg/dL to a peak of about 7% in the third quarter of 2014; an increase of approximately 50%. The percentage of blood lead level ≥5 µg/dL in the first quarter of 2015 then dropped to 2.3%; which was the same percentage as the first quarter of 2014 (prior to the Flint River water source change). The Flint quarterly blood lead level peak then rose to about 6% blood lead levels ≥ 5 µg/dL in the third quarter of 2015; and then declined to about 2.5% in the fourth quarter of 2015. Soil lead data collected by Edible Flint food collaborative reveal generally higher soil lead values in the metropolitan center for Flint; with lower values in the outskirts of the city. The questions that are not being asked is why did children’s blood lead levels display a seasonal blood lead pattern before the introduction of the new water supply in Flint; and what are the implications of these seasonal blood lead patterns? Based upon previous findings in Detroit and other North American cities we infer that resuspension to the air of lead in the form of dust from lead contaminated soils in Flint appears to be a persistent contribution to lead exposure of Flint children even before the change in the water supply from Lake Huron to the Flint River.

Concepts: Water management, Water resources, Water quality, Michigan, Water supply, Lead poisoning, Blood lead level, 2010s


Plastic pollution in the world’s oceans has received much attention, but there has been increasing concern about the high concentrations of plastic debris in the Laurentian Great Lakes. Using census data and methodologies used to study ocean debris we derive a first estimate of 9887 metric tonnes per year of plastic debris entering the Great Lakes. These estimates are translated into population-dependent particle inputs which are advected using currents from a hydrodynamic model to map the spatial distribution of plastic debris in the Great Lakes. Model results compare favorably with previously published sampling data. The samples are used to calibrate the model to derive surface microplastic mass estimates of 0.0211 metric tonnes in Lake Superior, 1.44 metric tonnes in Huron, and 4.41 metric tonnes in Erie. These results have many applications, including informing cleanup efforts, helping target pollution prevention, and understanding the inter-state or international flows of plastic pollution.

Concepts: Lake, Sea, Ocean, Lake Superior, Michigan, Great Lakes, Lake Huron, Lake Michigan


EuroAmerican land-use and its legacies have transformed forest structure and composition across the United States (US). More accurate reconstructions of historical states are critical to understanding the processes governing past, current, and future forest dynamics. Here we present new gridded (8x8km) reconstructions of pre-settlement (1800s) forest composition and structure from the upper Midwestern US (Minnesota, Wisconsin, and most of Michigan), using 19th Century Public Land Survey System (PLSS), with estimates of relative composition, above-ground biomass, stem density, and basal area for 28 tree types. This mapping is more robust than past efforts, using spatially varying correction factors to accommodate sampling design, azimuthal censoring, and biases in tree selection.

Concepts: United States, Minnesota, Michigan, Kentucky, Midwestern United States, Wisconsin, Public Land Survey System, Great Lakes region


Some of the most pivotal questions in human history necessitate the investigation of archaeological sites that are now under water. Nine thousand years ago, the Alpena-Amberley Ridge (AAR) beneath modern Lake Huron was a dry land corridor that connected northeast Michigan to southern Ontario. The newly discovered Drop 45 Drive Lane is the most complex hunting structure found to date beneath the Great Lakes. The site and its associated artifacts provide unprecedented insight into the social and seasonal organization of prehistoric caribou hunting. When combined with environmental and simulation studies, it is suggested that distinctly different seasonal strategies were used by early hunters on the AAR, with autumn hunting being carried out by small groups, and spring hunts being conducted by larger groups of cooperating hunters.

Concepts: Lake, Lake Superior, Ontario, Michigan, Great Lakes, Lake Huron, Lake Michigan, Lake Erie


This study evaluates atmospheric concentrations of soil and Pb aerosols, and blood lead levels (BLLs) in 367,839 children (ages 0-10) in Detroit, Michigan USA from 2001 to 2009 to test a hypothesized soil → air dust → child pathway of contemporary Pb risk. Atmospheric soil and Pb show near-identical seasonal properties that match seasonal variation in child BLLs. Resuspended soil appears to be a significant underlying source of atmospheric Pb. A 1% increase in the amount of resuspended soil results in a 0.39% increase in the concentration of Pb in the atmosphere (95% CI, 0.28 to 0.50%). In turn, atmospheric Pb significantly explains age-dependent variation in children’s BLLs. Other things held equal, a change of 0.0069 μg/m(3) in atmospheric Pb increases BLL of a child 1 year of age by 10%, while approximately 3 times the concentration of Pb in air (0.023 μg/m(3)) is required to induce the same increase in BLL of a child 7 years of age. Similarly, a 0.0069 μg/m(3) change in air Pb increases the odds of a child < 1 year of age having a BLL ≥ 5 μg/dL by a multiplicative factor of 1.32 (95% CI, 1.26 to 1.37). Overall, the resuspension of Pb contaminated soil explains observed seasonal variation in child BLLs.

Concepts: Scientific method, Earth, Concentration, Child, Atmosphere, Michigan, Weathering