Last data update: Jun 24, 2024. (Total: 47078 publications since 2009)
Records 1-11 (of 11 Records) |
Query Trace: Batten B [original query] |
---|
Notes from the field: update on Lyme carditis, groups at high risk, and frequency of associated sudden cardiac death - United States
Forrester JD , Meiman J , Mullins J , Nelson R , Ertel SH , Cartter M , Brown CM , Lijewski V , Schiffman E , Neitzel D , Daly ER , Mathewson AA , Howe W , Lowe LA , Kratz NR , Semple S , Backenson PB , White JL , Kurpiel PM , Rockwell R , Waller K , Johnson DH , Steward C , Batten B , Blau D , DeLeon-Carnes M , Drew C , Muehlenbachs A , Ritter J , Sanders J , Zaki SR , Molins C , Schriefer M , Perea A , Kugeler K , Nelson C , Hinckley A , Mead P . MMWR Morb Mortal Wkly Rep 2014 63 (43) 982-983 On December 13, 2013, MMWR published a report describing three cases of sudden cardiac death associated with Lyme carditis. State public health departments and CDC conducted a follow-up investigation to determine 1) whether carditis was disproportionately common among certain demographic groups of patients diagnosed with Lyme disease, 2) the frequency of death among patients diagnosed with Lyme disease and Lyme carditis, and 3) whether any additional deaths potentially attributable to Lyme carditis could be identified. Lyme disease cases are reported to CDC through the Nationally Notifiable Disease Surveillance System; reporting of clinical features, including Lyme carditis, is optional. For surveillance purposes, Lyme carditis is defined as acute second-degree or third-degree atrioventricular conduction block accompanying a diagnosis of Lyme disease. During 2001-2010, a total of 256,373 Lyme disease case reports were submitted to CDC, of which 174,385 (68%) included clinical information. Among these, 1,876 (1.1%) were identified as cases of Lyme carditis. Median age of patients with Lyme carditis was 43 years (range = 1-99 years); 1,209 (65%) of the patients were male, which is disproportionately larger than the male proportion among patients with other clinical manifestations (p<0.001). Of cases with this information available, 69% were diagnosed during the months of June-August, and 42% patients had an accompanying erythema migrans, a characteristic rash. Relative to patients aged 55-59 years, carditis was more common among men aged 20-39 years, women aged 25-29 years, and persons aged ≥75 years. |
Phylogeography of Rickettsia rickettsii genotypes associated with fatal Rocky Mountain spotted fever.
Paddock CD , Denison AM , Lash RR , Liu L , Batten BC , Dahlgren FS , Kanamura CT , Angerami RN , Pereira Dos Santos FC , Brasil Martines R , Karpathy SE . Am J Trop Med Hyg 2014 91 (3) 589-97 ![]() Rocky Mountain spotted fever (RMSF), a tick-borne zoonosis caused by Rickettsia rickettsii, is among the deadliest of all infectious diseases. To identify the distribution of various genotypes of R. rickettsii associated with fatal RMSF, we applied molecular typing methods to samples of DNA extracted from formalin-fixed, paraffin-embedded tissue specimens obtained at autopsy from 103 case-patients from seven countries who died of RMSF. Complete sequences of one or more intergenic regions were amplified from tissues of 30 (29%) case-patients and revealed a distribution of genotypes consisting of four distinct clades, including the Hlp clade, regarded previously as a non-pathogenic strain of R. rickettsii. Distinct phylogeographic patterns were identified when composite case-patient and reference strain data were mapped to the state and country of origin. The phylogeography of R. rickettsii is likely determined by ecological and environmental factors that exist independently of the distribution of a particular tick vector. |
Exserohilum infections associated with contaminated steroid injections: a clinicopathologic review of 40 cases
Ritter JM , Muehlenbachs A , Blau DM , Paddock CD , Shieh WJ , Drew CP , Batten BC , Bartlett JH , Metcalfe MG , Pham CD , Lockhart SR , Patel M , Liu L , Jones TL , Greer PW , Montague JL , White E , Rollin DC , Seales C , Stewart D , Deming MV , Brandt ME , Zaki SR . Am J Pathol 2013 183 (3) 881-92 September 2012 marked the beginning of the largest reported outbreak of infections associated with epidural and intra-articular injections. Contamination of methylprednisolone acetate with the black mold, Exserohilum rostratum, was the primary cause of the outbreak, with >13,000 persons exposed to the potentially contaminated drug, 741 confirmed drug-related infections, and 55 deaths. Fatal meningitis and localized epidural, paraspinal, and peripheral joint infections occurred. Tissues from 40 laboratory-confirmed cases representing these various clinical entities were evaluated by histopathological analysis, special stains, and IHC to characterize the pathological features and investigate the pathogenesis of infection, and to evaluate methods for detection of Exserohilum in formalin-fixed, paraffin-embedded (FFPE) tissues. Fatal cases had necrosuppurative to granulomatous meningitis and vasculitis, with thrombi and abundant angioinvasive fungi, with extensive involvement of the basilar arterial circulation of the brain. IHC was a highly sensitive method for detection of fungus in FFPE tissues, demonstrating both hyphal forms and granular fungal antigens, and PCR identified Exserohilum in FFPE and fresh tissues. Our findings suggest a pathogenesis for meningitis involving fungal penetration into the cerebrospinal fluid at the injection site, with transport through cerebrospinal fluid to the basal cisterns and subsequent invasion of the basilar arteries. Further studies are needed to characterize Exserohilum and investigate the potential effects of underlying host factors and steroid administration on the pathogenesis of infection. |
A new phlebovirus associated with severe febrile illness in Missouri.
McMullan LK , Folk SM , Kelly AJ , MacNeil A , Goldsmith CS , Metcalfe MG , Batten BC , Albarino CG , Zaki SR , Rollin PE , Nicholson WL , Nichol ST . N Engl J Med 2012 367 (9) 834-41 ![]() Two men from northwestern Missouri independently presented to a medical facility with fever, fatigue, diarrhea, thrombocytopenia, and leukopenia, and both had been bitten by ticks 5 to 7 days before the onset of illness. Ehrlichia chaffeensis was suspected as the causal agent but was not found on serologic analysis, polymerase-chain-reaction (PCR) assay, or cell culture. Electron microscopy revealed viruses consistent with members of the Bunyaviridae family. Next-generation sequencing and phylogenetic analysis identified the viruses as novel members of the phlebovirus genus. Although Koch's postulates have not been completely fulfilled, we believe that this phlebovirus, which is novel in the Americas, is the cause of this clinical syndrome. |
Using near real-time morbidity data to identify heat-related illness prevention strategies in North Carolina
Rhea S , Ising A , Fleischauer AT , Deyneka L , Vaughan-Batten H , Waller A . J Community Health 2012 37 (2) 495-500 Timely public health interventions reduce heat-related illnesses (HRIs). HRI emergency department (ED) visit data provide near real-time morbidity information to local and state public health practitioners and may be useful in directing HRI prevention efforts. This study examined statewide HRI ED visits in North Carolina (NC) from 2008-2010 by age group, month, ED disposition, chief complaint, and triage notes. The mean number of HRI ED visits per day was compared to the maximum daily temperature. The percentage of HRI ED visits to all ED visits was highest in June (0.25%). 15-18 year-olds had the highest percentage of HRI visits and were often seen for sports-related heat exposures. Work-related HRI ED visits were more common than other causes in 19-45 year-olds. Individuals ≥65 years were more likely admitted to the hospital than younger individuals. The mean daily number of HRI ED visits increased by 1.4 for each 1 degrees F (degree Fahrenheit) increase from 90 degrees F to 98 degrees F and by 15.8 for each 1 degrees F increase from 98 degrees F to 100 degrees F. Results indicate that HRI prevention efforts in NC should be emphasized in early summer and targeted to adolescents involved in organized sports, young adults with outdoor occupations, and seniors. At a maximum daily temperature of 98 degrees F, there was a substantial increase in the average daily number of HRI ED visits. ED visit data provide timely, sentinel HRI information. Analysis of this near real-time morbidity data may assist local and state public health practitioners in identification of HRI prevention strategies that are especially relevant to their jurisdictions. |
Trajectories of kidney function decline in the 2 years before initiation of long-term dialysis
O'Hare AM , Batten A , Burrows NR , Pavkov ME , Taylor L , Gupta I , Todd-Stenberg J , Maynard C , Rodriguez RA , Murtagh FE , Larson EB , Williams DE . Am J Kidney Dis 2012 59 (4) 513-22 BACKGROUND: Little is known about patterns of kidney function decline leading up to the initiation of long-term dialysis. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: 5,606 Veterans Affairs patients who initiated long-term dialysis in 2001-2003. PREDICTOR: Trajectory of estimated glomerular filtration rate (eGFR) during the 2-year period before initiation of long-term dialysis. OUTCOMES & MEASUREMENTS: Patient characteristics and care practices before and at the time of dialysis initiation and survival after initiation. RESULTS: We identified 4 distinct trajectories of eGFR during the 2-year period before dialysis initiation: 62.8% of patients had persistently low level of eGFR <30 mL/min/1.73 m(2) (mean eGFR slope, 7.7 +/- 4.7 [SD] mL/min/1.73 m(2) per year), 24.6% had progressive loss of eGFR from levels of approximately 30-59 ml/min/1.73 m(2) (mean eGFR slope, 16.3 +/- 7.6 mL/min/1.73 m(2) per year), 9.5% had accelerated loss of eGFR from levels >60 mL/min/1.73 m(2) (mean eGFR slope, 32.3 +/- 13.4 mL/min/1.73 m(2) per year), and 3.1% experienced catastrophic loss of eGFR from levels >60 mL/min/1.73 m(2) within 6 months or less. Patients with steeper eGFR trajectories were more likely to have been hospitalized and have an inpatient diagnosis of acute kidney injury. They were less likely to have received recommended predialysis care and had a higher risk of death in the first year after dialysis initiation. CONCLUSIONS: There is substantial heterogeneity in patterns of kidney function loss leading up to the initiation of long-term dialysis perhaps calling for a more flexible approach toward preparing for end-stage renal disease. |
A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009
Neil KP , Sodha SV , Lukwago L , Tipo SO , Mikoleit M , Simington SD , Mukobi P , Balinandi S , Majalija S , Ayers J , Kagirita A , Wefula E , Asiimwe F , Kweyamba V , Talkington D , Shieh WJ , Adem P , Batten BC , Zaki SR , Mintz E . Clin Infect Dis 2012 54 (8) 1091-9 ![]() BACKGROUND: Salmonella enterica serovar Typhi (Salmonella Typhi) causes an estimated 22 million typhoid fever cases and 216,000 deaths annually worldwide. In Africa, the lack of laboratory diagnostic capacity limits the ability to recognize endemic typhoid fever and to detect outbreaks. We report a large laboratory-confirmed outbreak of typhoid fever in Uganda with a high proportion of intestinal perforations (IPs). METHODS: A suspected case of typhoid fever was defined as fever and abdominal pain in a person with either vomiting, diarrhea, constipation, headache, weakness, arthralgia, poor response to antimalarial medications, or IP. From March 4, 2009 to April 17, 2009, specimens for blood and stool cultures and serology were collected from suspected cases. Antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE) were performed on Salmonella Typhi isolates. Surgical specimens from patients with IP were examined. A community survey was conducted to characterize the extent of the outbreak. RESULTS: From December 27, 2007 to July 30, 2009, 577 cases, 289 hospitalizations, 249 IPs, and 47 deaths from typhoid fever occurred; Salmonella Typhi was isolated from 27 (33%) of 81 patients. Isolates demonstrated multiple PFGE patterns and uniform susceptibility to ciprofloxacin. Surgical specimens from 30 patients were consistent with typhoid fever. Estimated typhoid fever incidence in the community survey was 8092 cases per 100,000 persons. CONCLUSIONS: This typhoid fever outbreak was detected because of an elevated number of IPs. Underreporting of milder illnesses and delayed and inadequate antimicrobial treatment contributed to the high perforation rate. Enhancing laboratory capacity for detection is critical to improving typhoid fever control. |
Severe Leptospirosis similar to pandemic (H1N1) 2009, Florida and Missouri, USA
Lo YC , Kintziger KW , Carson HJ , Patrick SL , Turabelidze G , Stanek D , Blackmore C , Lingamfelter D , Dudley MH , Shadomy SV , Shieh WJ , Drew CP , Batten BC , Zaki SR . Emerg Infect Dis 2011 17 (6) 1145-6 Leptospirosis is caused by pathogenic spirochetes of the genus Leptospira and transmitted through direct contact of skin or mucous membranes with urine or tissues of Leptospira-infected animals or through indirect contact with contaminated freshwater or soil. Leptospirosis shares common clinical signs with influenza, including fever, headache, myalgia, and sometimes cough and gastrointestinal symptoms. During 2009, acute complicated influenza-like illness (ILI) and rapid progressive pneumonia were often attributed to pandemic (H1N1) 2009; however, alternative final diagnoses were reported to be common. We report 3 cases of severe leptospirosis in Florida and Missouri with clinical signs similar to those of pandemic (H1N1) 2009. |
Tracking vaccine-safety inquiries to detect signals and monitor public concerns
Miller E , Batten B , Hampton L , Campbell SR , Gao J , Iskander J . Pediatrics 2011 127 Suppl 1 S87-91 BACKGROUND: The Centers for Disease Control and Prevention frequently receives inquiries from health care providers, public health officials, and the general public seeking data or guidance on vaccine-safety issues. Past inquiries to public health authorities identified potential problems including viscerotropic illness rarely associated with yellow fever vaccination. OBJECTIVE: To systematically describe vaccine-safety inquiries received at the Centers for Disease Control and Prevention. METHODS: External and internal inquiries were recorded in a database from May 1, 2002 to May 31, 2009. Key variables analyzed included the source of the question, the type of information being sought, and the vaccine type(s) associated with the inquiry. RESULTS: A total of 983 vaccine-safety inquiries were answered and analyzed. Health care workers were the source of 43% of the questions, and the general public accounted for 19% of the questions. Nearly half of the requests (49%) concerned information about the Vaccine Adverse Event Reporting System, and nearly one-fourth (21%) were requests from providers for clinical guidance. The most frequent specific topics of inquiry and vaccines involved were neurologic adverse events (AEs) temporally associated with vaccination (17%) and safety of all vaccines or childhood vaccines (20%), respectively. CONCLUSIONS: Questions about rare but potentially serious AEs and general concerns about vaccine safety were encountered relatively frequently. The substantial number of clinically focused inquiries may indicate a need for more provider support tools and resources. Tracking of inquiries can supplement information received through vaccine AE reporting and contribute to an enhanced scientific and communications response to vaccine-safety concerns. |
Diagnosis of influenza from respiratory autopsy tissues: detection of virus by real-time reverse transcription-PCR in 222 cases.
Denison AM , Blau DM , Jost HA , Jones T , Rollin D , Gao R , Liu L , Bhatnagar J , Deleon-Carnes M , Shieh WJ , Paddock CD , Drew C , Adem P , Emery SL , Shu B , Wu KH , Batten B , Greer PW , Smith CS , Bartlett J , Montague JL , Patel M , Xu X , Lindstrom S , Klimov AI , Zaki SR . J Mol Diagn 2011 13 (2) 123-8 ![]() The recent influenza pandemic, caused by a novel H1N1 influenza A virus, as well as the seasonal influenza outbreaks caused by varieties of influenza A and B viruses, are responsible for hundreds of thousands of deaths worldwide. Few studies have evaluated the utility of real-time reverse transcription-PCR to detect influenza virus RNA from formalin-fixed, paraffin-embedded tissues obtained at autopsy. In this work, respiratory autopsy tissues from 442 suspect influenza cases were tested by real-time reverse transcription-PCR for seasonal influenza A and B and 2009 pandemic influenza A (H1N1) viruses and the results were compared to those obtained by immunohistochemistry. In total, 222 cases were positive by real-time reverse transcription-PCR, and of 218 real-time, reverse transcription-PCR-positive cases also tested by immunohistochemistry, only 107 were positive. Although formalin-fixed, paraffin-embedded tissues can be used for diagnosis, frozen tissues offer the best chance to make a postmortem diagnosis of influenza because these tissues possess nucleic acids that are less degraded and, as a consequence, provide longer sequence information than that obtained from fixed tissues. We also determined that testing of all available respiratory tissues is critical for optimal detection of influenza virus in postmortem tissues. |
2009 pandemic influenza A (H1N1): pathology and pathogenesis of 100 fatal cases in the United States
Shieh WJ , Blau DM , Denison AM , Deleon-Carnes M , Adem P , Bhatnagar J , Sumner J , Liu L , Patel M , Batten B , Greer P , Jones T , Smith C , Bartlett J , Montague J , White E , Rollin D , Gao R , Seales C , Jost H , Metcalfe M , Goldsmith CS , Humphrey C , Schmitz A , Drew C , Paddock C , Uyeki TM , Zaki SR . Am J Pathol 2010 177 (1) 166-75 In the spring of 2009, a novel influenza A (H1N1) virus emerged in North America and spread worldwide to cause the first influenza pandemic since 1968. During the first 4 months, over 500 deaths in the United States had been associated with confirmed 2009 pandemic influenza A (H1N1) [2009 H1N1] virus infection. Pathological evaluation of respiratory specimens from initial influenza-associated deaths suggested marked differences in viral tropism and tissue damage compared with seasonal influenza and prompted further investigation. Available autopsy tissue samples were obtained from 100 US deaths with laboratory-confirmed 2009 H1N1 virus infection. Demographic and clinical data of these case-patients were collected, and the tissues were evaluated by multiple laboratory methods, including histopathological evaluation, special stains, molecular and immunohistochemical assays, viral culture, and electron microscopy. The most prominent histopathological feature observed was diffuse alveolar damage in the lung in all case-patients examined. Alveolar lining cells, including type I and type II pneumocytes, were the primary infected cells. Bacterial co-infections were identified in >25% of the case-patients. Viral pneumonia and immunolocalization of viral antigen in association with diffuse alveolar damage are prominent features of infection with 2009 pandemic influenza A (H1N1) virus. Underlying medical conditions and bacterial co-infections contributed to the fatal outcome of this infection. More studies are needed to understand the multifactorial pathogenesis of this infection. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Jun 24, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure