We examined 5 tularemia cases in Arizona, USA, during 2015–2017. All were caused by Francisella tularensis group A.II. Genetically similar isolates were found across large spatial and temporal distances, suggesting that group A.II strains are dispersed across long distances by wind and exhibit low replication rates in the environment.

Individuals living in congregate settings, including those in group homes, have been disproportionately impacted by COVID-19 and may be at increased risk of exposure or infection due to underlying illness. In mid-May 2020, local public health officials responded to an outbreak of COVID-19 among staff and residents associated with a multi-residential group home that provides care for adults with intellectual and developmental disabilities. Samples were collected at 16 of the homes. In four of the homes all the residents tested positive, and in the remaining 12 houses where samples were collected, all residents tested negative. Of the 152 individuals tested, 15/58 (25.9%) residents and 27/94 (28.7%) staff were positive for SARS-CoV-2, including eight hospitalizations and four deaths. Phylogenetic analysis of genomes from this outbreak in the context of genomes from Northern Arizona shows that very few mutations separate the samples from this outbreak. A potential transmission network was developed to illustrate person-place epidemiologic linkages and further demonstrates the dynamic connections between staff and residents with respect to each group home location. Epidemiologic and genomic evidence correlate, and suggest that asymptomatic infected staff likely introduced and spread COVID-19 in this setting. Implementation of public health prevention measures alongside rapid genomic analysis can help guide policy development and guide management efforts to prevent and mitigate future outbreaks.

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The epidemiological situation in Switzerland was characterised by a substantial decline in the number of AIDS cases and HIV-related deaths following the introduction of highly active antiretroviral therapy (HAART). The number of new HIV infections, has, however increased in recent years and AIDS cases and related deaths are no longer declining. We discuss three examples of issues that are relevant to epidemiology and public health in order to illustrate the importance of the study in this context: (i) use of SHCS data to inform the interpretation of routine surveillance data based on reports from physicians and laboratories to the Federal Office of Public Health (FOPH); (ii) analyses of access to and utilization of HAART across different groups of study participants, including migrant populations, those with lower socio-economic status and patients infected through intravenous drug use; and (iii) the monitoring of trends in self-reported sexual behaviour, including condom use with stable and casual partners. The examples demonstrate that the study is an important resource for epidemiological analysis and public health surveillance and action in Switzerland.