Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Adam JK[original query] |
---|
Clinician survey to determine knowledge of dengue and clinical management practices, Texas, 2014
Adam JK , Abeyta R , Smith B , Gaul L , Thomas DL , Han G , Sharp TM , Waterman SH , Tomashek KM . Am J Trop Med Hyg 2017 96 (3) 708-714 Dengue, a mosquito-borne viral disease, is increasingly being identified as a cause of outbreaks in the United States. During July-December 2013, a total of three south Texas counties reported 53 laboratory-confirmed dengue cases; 26 were locally acquired, constituting the largest outbreak in Texas since 2005. Because dengue outbreaks are expected to continue in south Texas and early case identification and timely treatment can reduce mortality, we sought to determine clinicians' knowledge of dengue and its clinical management. A survey was sent to 2,375 south Texas clinicians; 217 (9%) completed the survey. Approximately half of participants demonstrated knowledge needed to identify dengue cases, including symptoms (56%), early indicators of shock (54%), or timing of thrombocytopenia (48%). Fewer than 20% correctly identified all prevention messages, severe dengue warning signs, or circumstances in which a dengue patient should return for care. Knowledge of clinical management was limited; few participants correctly identified scenarios when plasma leakage occurred (10%) or a crystalloid solution was indicated (7%); however, 45% correctly identified when a blood transfusion was indicated. Because of the ongoing threat of dengue, we recommend clinicians in south Texas receive dengue clinical management training. |
Reemergence of Dengue in Southern Texas, 2013.
Thomas DL , Santiago GA , Abeyta R , Hinojosa S , Torres-Velasquez B , Adam JK , Evert N , Caraballo E , Hunsperger E , Munoz-Jordan JL , Smith B , Banicki A , Tomashek KM , Gaul L , Sharp TM . Emerg Infect Dis 2016 22 (6) 1002-7 During a dengue epidemic in northern Mexico, enhanced surveillance identified 53 laboratory-positive cases in southern Texas; 26 (49%) patients acquired the infection locally, and 29 (55%) were hospitalized. Of 83 patient specimens that were initially IgM negative according to ELISA performed at a commercial laboratory, 14 (17%) were dengue virus positive by real-time reverse transcription PCR performed at the Centers for Disease Control and Prevention. Dengue virus types 1 and 3 were identified, and molecular phylogenetic analysis demonstrated close identity with viruses that had recently circulated in Mexico and Central America. Of 51 household members of 22 dengue case-patients who participated in household investigations, 6 (12%) had been recently infected with a dengue virus and reported no recent travel, suggesting intrahousehold transmission. One household member reported having a recent illness consistent with dengue. This outbreak reinforces emergence of dengue in southern Texas, particularly when incidence is high in northern Mexico. |
Notes from the field: fatal rat-bite fever in a child - San Diego County, California, 2013
Adam JK , Varan AK , Pong AL , McDonald EC . MMWR Morb Mortal Wkly Rep 2014 63 (50) 1210-1 In August 2013, the County of San Diego Health and Human Services Agency was notified of a fatal case of rat-bite fever (RBF) in a previously healthy male, aged 10 years, who owned pet rats. Two days before his death, the patient experienced rigors, fevers, vomiting, headaches, and leg pains. His physician noted a fever of 102.6 degrees F (39.2 masculineC), documented a normal examination, diagnosed viral gastroenteritis, and prescribed anti-nausea medication. During the next 24 hours, the patient experienced vomiting and persistent fever. He was confused and weak before collapsing at home. Paramedics reported the patient was unresponsive and had dilated pupils; resuscitation was initiated in the field and was continued for >1 hour after arrival at the emergency department but was unsuccessful. A complete blood count performed during resuscitation revealed anemia (hemoglobin 10.0 g/dL [normal = 13.5-18.0 g/dL], thrombocytopenia (platelets 40,000/microL [normal = 140,000-440,000/microL]), leukocytosis (white blood cells 17,900 cells/microL [normal = 4,000-10,500/microL]) with 16% band neutrophils; the patient also had evidence of disseminated intravascular coagulation. No rash or skin breakdown was noted. Lung, liver, and epiglottis tissue collected postmortem was positive for Streptobacillus moniliformis DNA by polymerase chain reaction. |
Fatal influenza outbreak aboard a sport fishing vessel in San Diego, California
Adam JK , Varan AK , Kao AS , McDonald EC , Waterman SH . Travel Med Infect Dis 2014 13 (1) 102-3 In January 2014, the Centers for Disease Control and Prevention (CDC) was notified about a death aboard a sport fishing vessel on a 16-day cruise off the Baja California peninsula. The male passenger, aged 70 years, had chronic obstructive pulmonary disease, coronary artery disease, was obese, and had not received the seasonal influenza vaccine. He had chills, productive cough, and dyspnea before his death on January 22, 2014. A second passenger, unrelated to the decedent, was medically evacuated on January 24, 2014, while at an international port due to respiratory illness. Upon return of the vessel to a U.S. port on January 27, 2014, federal and local public health officials assessed symptoms, offered influenza testing (rapid test and nasal swab for reverse transcription polymerase chain reaction [RT-PCR]) for all persons onboard, and planned for interviews to assess seasonal influenza vaccination beliefs. | Among 25 passengers (including the evacuee) and nine crew, all male adults, seven passengers (28%) and two crew (22%) met criteria for influenza-like illness (ILI), defined as subjective fever plus either cough or sore throat. Subjective fever could not be confirmed for the decedent via proxy interview; hence, he was not deemed to meet ILI criteria. Among persons with ILI, the median age was 52 years (range: 43–65 years). Illness onset dates among persons with ILI ranged from 13 to 23 January, 2014. The majority (78%) with ILI had not received the 2013–2014 influenza vaccine. The ILI attack rate was 26% among all passengers and crew, 28% among the unvaccinated, and 22% among the vaccinated. Twenty-seven passengers and crew (79%) onboard agreed to influenza testing, including seven of the nine persons with ILI. Among persons with ILI, specimens were collected a median of 12 days after illness onset (range: 5–15 days). All rapid tests were negative. Two (7.4%) passengers were positive for H1N1pdm09 virus by RT-PCR; neither met criteria for ILI. The evacuated passenger was hospitalized; convalescent serum was positive for influenza A H1N1pdm09 virus by hemagglutination inhibition assay. Additionally, the decedent had a post-mortem nasopharyngeal swab positive for H1N1pdm09 virus by RT-PCR; cause of death by autopsy report was acute viral influenza and bacterial bronchopneumonia. |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 13, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure