Last data update: Nov 04, 2024. (Total: 48056 publications since 2009)
Records 1-28 (of 28 Records) |
Query Trace: Bonilla L[original query] |
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Deaths of U.S. citizens undergoing cosmetic surgery - Dominican Republic, 2009-2022
Hudson M , Matos JA , Alvarez B , Safstrom J , Torres F , Premjee S , Bonilla L , Park B , Bancroft E , Garcia M . MMWR Morb Mortal Wkly Rep 2024 73 (3) 62-65 Although infections resulting from cosmetic surgery performed outside the United States have been regularly reported, deaths have rarely been identified. During 2009-2022, 93 U.S. citizens died after receiving cosmetic surgery in the Dominican Republic. The number of deaths increased from a mean of 4.1 per year during 2009-2018 to a mean of 13.0 during 2019-2022 with a peak in of 17 in 2020. A subset of post-cosmetic surgery deaths occurring during peak years was investigated, and most deaths were found to be the result of embolic events (fat emboli or venous thromboembolism) for which a high proportion of the patients who died had risk factors, including obesity and having multiple procedures performed during the same operation. These risk factors might have been mitigated or prevented with improved surgical protocols and postoperative medical care, including prophylactic measures against venous thromboembolism. U.S. citizens interested in receiving elective cosmetic surgery outside the United States should consult with their health care professionals regarding their risk for adverse outcomes. Public health authorities can support provider education on the importance of preoperative patient evaluation and the potential danger of performing multiple cosmetic procedures in one operation. |
The effects of policy changes and human mobility on the COVID-19 epidemic in the Dominican Republic, 2020-2021
Maloney P , Kompaniyets L , Yusuf H , Bonilla L , Figueroa C , Garcia M . Prev Med Rep 2023 36 102459 Recent advances in technology can be leveraged to enhance public health research and practice. This study aimed to assess the effects of mobility and policy changes on COVID-19 case growth and the effects of policy changes on mobility using data from Google Mobility Reports, information on public health policy, and COVID-19 testing results. Multiple bivariate regression analyses were conducted to address the study objectives. Policies designed to limit mobility led to decreases in mobility in public areas. These policies also decreased COVID-19 case growth. Conversely, policies that did not restrict mobility led to increases in mobility in public areas and led to increases in COVID-19 case growth. Mobility increases in public areas corresponded to increases in COVID-19 case growth, while concentration of mobility in residential areas corresponded to decreases in COVID-19 case growth. Overall, restrictive policies were effective in decreasing COVID-19 incidence in the Dominican Republic, while permissive policies led to increases in COVID-19 incidence. |
Japanese encephalitis in a U.S. traveler returning from Vietnam, 2022
Janatpour ZC , Boatwright MA , Yousif SM , Bonilla MF , Fitzpatrick KA , Hills SL , Decker CF . Travel Med Infect Dis 2023 52 102536 Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus which is endemic throughout most of Asia and parts of the Western Pacific [1,2]. Since the availability of a JE vaccine in the United States (U.S.) in 1993, a total of 13 JE cases in U.S. travelers or expatriates have been reported [[3], [4], [5], [6]]. We describe a case of severe JE in an unvaccinated returning traveler. | | A 37-year-old woman presented to Cleveland Clinic in Abu Dhabi, United Arab Emirates with 4 days of headache, fever and confusion. The patient is a U.S. citizen and had been living in Abu Dhabi for the past 2 years. She had returned from a 2-week vacation to Vietnam, where she primarily stayed in urban locales. However, she did participate in a 2-day hike within the Sa Pa region of Northern Vietnam, where she stayed in unscreened lodging and sustained multiple mosquito bites despite using preventive measures. She had not received the JE vaccine prior to travel. Her symptoms began while still in country on day 13 of the 14-day trip. |
Lessons Learned from Programmatic Gains in HIV Service Delivery During the COVID-19 Pandemic - 41 PEPFAR-Supported Countries, 2020.
Fisher KA , Patel SV , Mehta N , Stewart A , Medley A , Dokubo EK , Shang JD , Wright J , Rodas J , Balachandra S , Kitenge F , Mpingulu M , García MC , Bonilla L , Quaye S , Melchior M , Banchongphanith K , Phokhasawad K , Nkanaunena K , Maida A , Couto A , Mizela J , Ibrahim J , Charles OO , Malamba SS , Musoni C , Bolo A , Bunga S , Lolekha R , Kiatchanon W , Bhatia R , Nguyen C , Aberle-Grasse J . MMWR Morb Mortal Wkly Rep 2022 71 (12) 447-452 The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) supports country programs in identifying persons living with HIV infection (PLHIV), providing life-saving treatment, and reducing the spread of HIV in countries around the world (1,2). CDC used Monitoring, Evaluation, and Reporting (MER) data* to assess the extent to which COVID-19 mitigation strategies affected HIV service delivery across the HIV care continuum(†) globally during the first year of the COVID-19 pandemic. Indicators included the number of reported HIV-positive test results, the number of PLHIV who were receiving antiretroviral therapy (ART), and the rates of HIV viral load suppression. Percent change in performance was assessed between countries during the first 3 months of 2020, before COVID-19 mitigation efforts began (January-March 2020), and the last 3 months of the calendar year (October-December 2020). Data were reviewed for all 41 countries to assess total and country-level percent change for each indicator. Then, qualitative data were reviewed among countries in the upper quartile to assess specific strategies that contributed to programmatic gains. Overall, positive percent change was observed in PEPFAR-supported countries in HIV treatment (5%) and viral load suppression (2%) during 2020. Countries reporting the highest gains across the HIV care continuum during 2020 attributed successes to reducing or streamlining facility attendance through strategies such as enhancing index testing (offering of testing to the biologic children and partners of PLHIV)(§) and community- and home-based testing; treatment delivery approaches; and improvements in data use through monitoring activities, systems, and data quality checks. Countries that reported program improvements during the first year of the COVID-19 pandemic offer important information about how lifesaving HIV treatment might be provided during a global public health crisis. |
Environmental Surveillance for Risk Assessment in the Context of a Phase 2 Clinical Trial of Type 2 Novel Oral Polio Vaccine in Panama.
Rojas-Bonilla M , Coulliette-Salmond A , Belgasmi H , Wong K , Sayyad L , Vega E , Grimoldi F , Oberste MS , Ruttimann R . Viruses 2021 13 (7) Environmental surveillance was recommended for risk mitigation in a novel oral polio vaccine-2 (nOPV2) clinical trial (M5-ABMG) to monitor excretion, potential circulation, and loss of attenuation of the two nOPV2 candidates. The nOPV2 candidates were developed to address the risk of poliovirus (PV) type 2 circulating vaccine-derived poliovirus (cVDPV) as part of the global eradication strategy. Between November 2018 and January 2020, an environmental surveillance study for the clinical trial was conducted in parallel to the M5-ABMG clinical trial at five locations in Panama. The collection sites were located upstream from local treatment plant inlets, to capture the excreta from trial participants and their community. Laboratory analyses of 49 environmental samples were conducted using the two-phase separation method. Novel OPV2 strains were not detected in sewage samples collected during the study period. However, six samples were positive for Sabin-like type 3 PV, two samples were positive for Sabin-like type 1 PV, and non-polio entero-viruses NPEVs were detected in 27 samples. One of the nOPV2 candidates has been granted Emergency Use Listing by the World Health Organization and initial use started in March 2021. This environmental surveillance study provided valuable risk mitigation information to support the Emergency Use Listing application. Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland. |
Functional connectivity of the reading network is associated with prenatal polybrominated diphenyl ether concentrations in a community sample of 5 year-old children: A preliminary study
Margolis AE , Banker S , Pagliaccio D , De Water E , Curtin P , Bonilla A , Herbstman JB , Whyatt R , Bansal R , Sjodin A , Milham MP , Peterson BS , Factor-Litvak P , Horton MK . Environ Int 2019 134 105212 Genetic factors explain 60 percent of variance in reading disorder. Exposure to neurotoxicants, including polybrominated diphenyl ethers (PBDEs), may be overlooked risk factors for reading problems. We used resting-state functional magnetic resonance imaging (rs-fMRI) to examine associations between prenatal PBDE concentrations and functional connectivity of a reading-related network (RN) in a community sample of 5-year-old children (N=33). Maternal serum PBDE concentrations ( summation operatorPBDE) were measured at 12.2+/-2.8weeks gestation (mean+/-SD). The RN was defined by 12 regions identified in prior task-based fMRI meta-analyses; global efficiency (GE) was used to measure network integration. Linear regression evaluated associations between summation operatorPBDE, word reading, and GE of the RN and the default mode network (DMN); the latter to establish specificity of findings. Weighted quantile sum regression analyses evaluated the contributions of specific PBDE congeners to observed associations. Greater RN efficiency was associated with better word reading in these novice readers. Children with higher summation operatorPBDE showed reduced GE of the RN; summation operatorPBDE was not associated with DMN efficiency, demonstrating specificity of our results. Consistent with prior findings, summation operatorPBDE was not associated word reading at 5-years-old. Altered efficiency and integration of the RN may underlie associations between summation operatorPBDE concentrations and reading problems observed previously in older children. |
National health information systems for achieving the Sustainable Development Goals
Suthar AB , Khalifa A , Joos O , Manders EJ , Abdul-Quader A , Amoyaw F , Aoua C , Aynalem G , Barradas D , Bello G , Bonilla L , Cheyip M , Dalhatu IT , De Klerk M , Dee J , Hedje J , Jahun I , Jantaramanee S , Kamocha S , Lerebours L , Lobognon LR , Lote N , Lubala L , Magazani A , Mdodo R , Mgomella GS , Monique LA , Mudenda M , Mushi J , Mutenda N , Nicoue A , Ngalamulume RG , Ndjakani Y , Nguyen TA , Nzelu CE , Ofosu AA , Pinini Z , Ramirez E , Sebastian V , Simanovong B , Son HT , Son VH , Swaminathan M , Sivile S , Teeraratkul A , Temu P , West C , Xaymounvong D , Yamba A , Yoka D , Zhu H , Ransom RL , Nichols E , Murrill CS , Rosen D , Hladik W . BMJ Open 2019 9 (5) e027689 OBJECTIVES: Achieving the Sustainable Development Goals will require data-driven public health action. There are limited publications on national health information systems that continuously generate health data. Given the need to develop these systems, we summarised their current status in low-income and middle-income countries. SETTING: The survey team jointly developed a questionnaire covering policy, planning, legislation and organisation of case reporting, patient monitoring and civil registration and vital statistics (CRVS) systems. From January until May 2017, we administered the questionnaire to key informants in 51 Centers for Disease Control country offices. Countries were aggregated for descriptive analyses in Microsoft Excel. RESULTS: Key informants in 15 countries responded to the questionnaire. Several key informants did not answer all questions, leading to different denominators across questions. The Ministry of Health coordinated case reporting, patient monitoring and CRVS systems in 93% (14/15), 93% (13/14) and 53% (8/15) of responding countries, respectively. Domestic financing supported case reporting, patient monitoring and CRVS systems in 86% (12/14), 75% (9/12) and 92% (11/12) of responding countries, respectively. The most common uses for system-generated data were to guide programme response in 100% (15/15) of countries for case reporting, to calculate service coverage in 92% (12/13) of countries for patient monitoring and to estimate the national burden of disease in 83% (10/12) of countries for CRVS. Systems with an electronic component were being used for case reporting, patient monitoring, birth registration and death registration in 87% (13/15), 92% (11/12), 77% (10/13) and 64% (7/11) of responding countries, respectively. CONCLUSIONS: Most responding countries have a solid foundation for policy, planning, legislation and organisation of health information systems. Further evaluation is needed to assess the quality of data generated from systems. Periodic evaluations may be useful in monitoring progress in strengthening and harmonising these systems over time. |
A preliminary study on prenatal polybrominated diphenyl ether serum concentrations and intrinsic functional network organization and executive functioning in childhood
de Water E , Curtin P , Zilverstand A , Sjodin A , Bonilla A , Herbstman JB , Ramirez J , Margolis AE , Bansal R , Whyatt RM , Peterson BS , Factor-Litvak P , Horton MK . J Child Psychol Psychiatry 2019 60 (9) 1010-1020 BACKGROUND: The prenatal period is a period of vulnerability during which neurotoxic exposures exert persistent changes in brain development and behavior. Polybrominated diphenyl ethers (PBDEs), used as flame retardants in commercial products, are known to be developmental neurotoxicants. PBDEs were phased out of use in the United States a decade ago, but exposure remains widespread due to their release from existing products and biopersistence. Despite consistent animal and epidemiological evidence of developmental neurotoxicity, the neural substrates linking prenatal PBDE serum concentrations to impaired neurodevelopment are poorly understood. METHODS: In the present study, we used resting state functional magnetic resonance imaging (fMRI) to examine associations between prenatal PBDE concentrations measured in maternal serum and intrinsic functional network organization (i.e., global and local efficiency; estimated using a graph-theoretical approach) in 5-year-old children (n = 34). We explored whether PBDE serum concentrations were associated with executive functioning (EF) assessed using a parent-report questionnaire (BRIEF-P) (n = 106) and whether changes in intrinsic functional network organization linked the association between prenatal PBDE serum concentrations and EF problems. RESULTS: Children with higher prenatal PBDE serum concentrations showed: (a) increased global efficiency of brain areas involved in visual attention (e.g., inferior occipital gyrus) (beta's = .01, FDR-corrected p's </= .05); (b) more reported EF problems (beta's = .001, FDR-corrected p's </= .05). Higher global efficiency of brain areas involved in visual attention was associated with more EF problems (beta's = .01, FDR-corrected p's < .05). CONCLUSIONS: Intrinsic functional network organization of visual attention brain areas linked prenatal PBDE concentrations to EF problems in childhood. Visual attention may contribute to the development of higher-order cognitive functions, such as EF, which could be explored in future studies. |
Rubella Virus-Associated Cutaneous Granulomatous Disease: a Unique Complication in Immune-Deficient Patients, Not Limited to DNA Repair Disorders.
Buchbinder D , Hauck F , Albert MH , Rack A , Bakhtiar S , Shcherbina A , Deripapa E , Sullivan KE , Perelygina L , Eloit M , Neven B , Perot P , Moshous D , Suarez F , Bodemer C , Bonilla FA , Vaz LE , Krol AL , Klein C , Seppanen M , Nugent DJ , Singh J , Ochs HD . J Clin Immunol 2019 39 (1) 81-89 The association of immunodeficiency-related vaccine-derived rubella virus (iVDRV) with cutaneous and visceral granulomatous disease has been reported in patients with primary immunodeficiency disorders (PIDs). The majority of these PID patients with rubella-positive granulomas had DNA repair disorders. To support this line of inquiry, we provide additional descriptive data on seven previously reported patients with Nijmegen breakage syndrome (NBS) (n = 3) and ataxia telangiectasia (AT) (n = 4) as well as eight previously unreported patients with iVDRV-induced cutaneous granulomas and DNA repair disorders including NBS (n = 1), AT (n = 5), DNA ligase 4 deficiency (n = 1), and Artemis deficiency (n = 1). We also provide descriptive data on several previously unreported PID patients with iVDRV-induced cutaneous granulomas including cartilage hair hypoplasia (n = 1), warts, hypogammaglobulinemia, immunodeficiency, myelokathexis (WHIM) syndrome (n = 1), MHC class II deficiency (n = 1), Coronin-1A deficiency (n = 1), X-linked severe combined immunodeficiency (X-SCID) (n = 1), and combined immunodeficiency without a molecular diagnosis (n = 1). At the time of this report, the median age of the patients with skin granulomas and DNA repair disorders was 9 years (range 3-18). Cutaneous granulomas have been documented in all, while visceral granulomas were observed in six cases (40%). All patients had received rubella virus vaccine. The median duration of time elapsed from vaccination to the development of cutaneous granulomas was 48 months (range 2-152). Hematopoietic cell transplantation was reported to result in scarring resolution of cutaneous granulomas in two patients with NBS, one patient with AT, one patient with Artemis deficiency, one patient with DNA Ligase 4 deficiency, one patient with MHC class II deficiency, and one patient with combined immunodeficiency without a known molecular etiology. Of the previously reported and unreported cases, the majority share the diagnosis of a DNA repair disorder. Analysis of additional patients with this complication may clarify determinants of rubella pathogenesis, identify specific immune defects resulting in chronic infection, and may lead to defect-specific therapies. |
Multistate Infestation with the Exotic Disease-Vector Tick Haemaphysalis longicornis - United States, August 2017-September 2018.
Beard CB , Occi J , Bonilla DL , Egizi AM , Fonseca DM , Mertins JW , Backenson BP , Bajwa WI , Barbarin AM , Bertone MA , Brown J , Connally NP , Connell ND , Eisen RJ , Falco RC , James AM , Krell RK , Lahmers K , Lewis N , Little SE , Neault M , Perez de Leon AA , Randall AR , Ruder MG , Saleh MN , Schappach BL , Schroeder BA , Seraphin LL , Wehtje M , Wormser GP , Yabsley MJ , Halperin W . MMWR Morb Mortal Wkly Rep 2018 67 (47) 1310-1313 Haemaphysalis longicornis is a tick indigenous to eastern Asia and an important vector of human and animal disease agents, resulting in such outcomes as human hemorrhagic fever and reduction of production in dairy cattle by 25%. H. longicornis was discovered on a sheep in New Jersey in August 2017 (1). This was the first detection in the United States outside of quarantine. In the spring of 2018, the tick was again detected at the index site, and later, in other counties in New Jersey, in seven other states in the eastern United States, and in Arkansas. The hosts included six species of domestic animals, six species of wildlife, and humans. To forestall adverse consequences in humans, pets, livestock, and wildlife, several critical actions are indicated, including expanded surveillance to determine the evolving distribution of H. longicornis, detection of pathogens that H. longicornis currently harbors, determination of the capacity of H. longicornis to serve as a vector for a range of potential pathogens, and evaluation of effective agents and methods for the control of H. longicornis. |
Detection and characterization of a novel spotted fever group Rickettsia genotype in Haemaphysalis leporispalustris from California, USA.
Eremeeva ME , Weiner LM , Zambrano ML , Dasch GA , Hu R , Vilcins I , Castro MB , Bonilla DL , Padgett KA . Ticks Tick Borne Dis 2018 9 (4) 814-818 The rabbit tick, Haemaphysalis leporispalustris Packard, is known for its association with Rickettsia rickettsii as it harbors both virulent and avirulent strains of this pathogen. In this manuscript we report findings and preliminary characterization of a novel spotted fever group rickettsia (SFGR) in rabbit ticks from California, USA. Rickettsia sp. CA6269 (proposed "Candidatus Rickettsia lanei") is most related to known R. rickettsii isolates but belongs to its own well-supported branch different from those of all R. rickettsii including strain Hlp2 and from Rickettsia sp. 364D (also known as R. philipii) and R. peacockii. This SFGR probably exhibits both transovarial and transstadial survival since it was found in both questing larvae and nymphs. Although this rabbit tick does not frequently bite humans, its role in maintenance of other rickettsial agents and this novel SFGR warrant further investigation. |
Using theory-based messages to motivate U.S. pregnant women to prevent cytomegalovirus infection: results from formative research
Levis DM , Hillard CL , Price SM , Reed-Gross E , Bonilla E , Amin M , Stowell JD , Clark R , Johnson D , Mask K , Carpentieri C , Cannon MJ . BMC Womens Health 2017 17 (1) 131 BACKGROUND: An estimated 1 in 150 infants is born each year with congenital cytomegalovirus (CMV); nearly 1 in 750 suffers permanent disabilities. Congenital CMV is the result of a pregnant woman becoming infected with CMV. Educating pregnant women about CMV is currently the best approach to prevention. Limited research is available on how to effectively communicate with women about CMV. We conducted formative research on fear appeals theory-based messages about CMV and prevention with U.S. women. Fear appeal theories suggest that message recipients will take action if they feel fear. METHODS: First, we conducted in-depth interviews (N = 32) with women who had young children who tested positive for CMV. Second, we conducted eight focus groups (N = 70) in two phases and two cities (Phase 2: Atlanta, GA; Phase 3: San Diego, CA) with pregnant women and non-pregnant women who had young children. Few participants knew about CMV before the focus groups. Participants reviewed and gave feedback on messages created around fear appeals theory-based communication concepts. The following concepts were tested in one or more of the three phases of research: CMV is severe, CMV is common, CMV is preventable, CMV preventive strategies are similar to other behavior changes women make during pregnancy, CMV preventive strategies can be incorporated in moderation to reduce exposure, and CMV is severe but preventable. RESULTS: Participants recommended communicating that CMV is common by using prevalence ratios (e.g., 1 in 150) or comparing CMV to other well-known disabilities. To convey the severity of CMV, participants preferred stories about CMV along with prevention strategies. Participants also welcomed prevention strategies when it included a message about risk reduction. In general, participants said messages were motivating, even if they felt that it could be difficult to make certain behavior changes. CONCLUSIONS: Findings from this research can contribute to future efforts to educate pregnant women about CMV, especially regarding use of fear appeals-based messages. Pregnant women may face certain challenges to practicing prevention strategies but, overall, are motivated make changes to increase their chances of having a healthy baby. |
Outbreak of severe histoplasmosis among tunnel workers - Dominican Republic, 2015
Armstrong PA , Beard JD , Bonilla L , Arboleda N , Lindsley MD , Chae S , Castillo D , Nunez R , Chiller T , de Perio MA , Pimentel R , Vallabhaneni S . Clin Infect Dis 2017 66 (10) 1550-1557 Background: Histoplasmosis is a fungal infection associated with exposure to bat guano. An outbreak of an unknown severe febrile illness occurred among tunnel workers in the Dominican Republic (DR), and resulted in several deaths. We conducted an investigation to confirm etiology and recommend control measures. Methods: A case was defined as fever and ≥2 symptoms consistent with histoplasmosis in a tunnel worker, July-September, 2015. We interviewed workers and family members, reviewed medical records, tested serum and urine for Histoplasma antigen/antibody, and conducted a cohort study to identify risk factors for histoplasmosis and severe infection (intensive care). Results: A crew of 36 male workers removed large amounts of bat guano from tunnels without respiratory protection for a median of 24 days per worker (range: 1-25). Median age was 32 years (range: 18-62); none were immunocompromised. Thirty (83%) workers had illness that met the case definition of whom 28 (93%) were hospitalized, 9 (30%) required intensive care, 6 (20%) required intubation, and 3 (10%) died. The median time from symptom onset to antifungal treatment was 6 days (range: 1-11). Twenty-two of 34 (65%) workers had laboratory evidence of histoplasmosis infection. Conclusions: Severe illnesses and death likely resulted from exposure to large inocula of Histoplasma capsulatum spores in an enclosed space, lack of respiratory protection, and delay in recognition and treatment. Clinician education about histoplasmosis, improved laboratory capacity to diagnose fungal infections, and occupational health guidance to protect workers against endemic fungi are recommended in the DR to prevent future outbreaks. |
High mortality and coinfection in a prospective cohort of human immunodeficiency virus/acquired immune deficiency syndrome patients with histoplasmosis in Guatemala
Samayoa B , Roy M , Cleveland AA , Medina N , Lau-Bonilla D , Scheel CM , Gomez BL , Chiller T , Arathoon E . Am J Trop Med Hyg 2017 97 (1) 42-48 Histoplasmosis is one of the most common and deadly opportunistic infections among persons living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome in Latin America, but due to limited diagnostic capacity in this region, few data on the burden and clinical characteristics of this disease exist. Between 2005 and 2009, we enrolled patients ≥ 18 years of age with suspected histoplasmosis at a hospital-based HIV clinic in Guatemala City. A case of suspected histoplasmosis was defined as a person presenting with at least three of five clinical or radiologic criteria. A confirmed case of histoplasmosis was defined as a person with a positive culture or urine antigen test for Histoplasma capsulatum. Demographic and clinical data were also collected and analyzed. Of 263 enrolled as suspected cases of histoplasmosis, 101 (38.4%) were confirmed cases. Median time to diagnosis was 15 days after presentation (interquartile range [IQR] = 5-23). Crude overall mortality was 43.6%; median survival time was 19 days (IQR = 4-69). Mycobacterial infection was diagnosed in 70 (26.6%) cases; 26 (25.7%) histoplasmosis cases were coinfected with mycobacteria. High mortality and short survival time after initial symptoms were observed in patients with histoplasmosis. Mycobacterial coinfection diagnoses were frequent, highlighting the importance of pursuing diagnoses for both diseases. |
Preliminary report of microcephaly potentially associated with Zika virus infection during pregnancy - Colombia, January-November 2016
Cuevas EL , Tong VT , Rozo N , Valencia D , Pacheco O , Gilboa SM , Mercado M , Renquist CM , Gonzalez M , Ailes EC , Duarte C , Godoshian V , Sancken CL , Turca AM , Calles DL , Ayala M , Morgan P , Perez EN , Bonilla HQ , Gomez RC , Estupinan AC , Gunturiz ML , Meaney-Delman D , Jamieson DJ , Honein MA , Martinez ML . MMWR Morb Mortal Wkly Rep 2016 65 (49) 1409-1413 In Colombia, approximately 105,000 suspected cases of Zika virus disease (diagnosed based on clinical symptoms, regardless of laboratory confirmation) were reported during August 9, 2015-November 12, 2016, including nearly 20,000 in pregnant women (1,2). Zika virus infection during pregnancy is a known cause of microcephaly and serious congenital brain abnormalities and has been associated with other birth defects related to central nervous system damage (3). Colombia's Instituto Nacional de Salud (INS) maintains national surveillance for birth defects, including microcephaly and other central nervous system defects. This report provides preliminary information on cases of congenital microcephaly identified in Colombia during epidemiologic weeks 5-45 (January 31-November 12) in 2016. During this period, 476 cases of microcephaly were reported, compared with 110 cases reported during the same period in 2015. The temporal association between reported Zika virus infections and the occurrence of microcephaly, with the peak number of reported microcephaly cases occurring approximately 24 weeks after the peak of the Zika virus disease outbreak, provides evidence suggesting that the period of highest risk is during the first trimester of pregnancy and early in the second trimester of pregnancy. Microcephaly prevalence increased more than fourfold overall during the study period, from 2.1 per 10,000 live births in 2015 to 9.6 in 2016. Ongoing population-based birth defects surveillance is essential for monitoring the impact of Zika virus infection during pregnancy on birth defects prevalence and measuring the success in preventing Zika virus infection and its consequences, including microcephaly. |
Associations of HIV testing, sexual risk and access to prevention among female sex workers in the Dominican Republic
Johnston LG , Bonilla L , Caballero T , Rodriguez M , Dolores Y , de la Rosa MA , Malla A , Burnett J , Terrero V , Martinez S , Morgan O . AIDS Behav 2016 21 (8) 2362-2371 The Caribbean region has one of the highest proportions of HIV in the general female population attributable to sex work. In 2008 (n = 1256) and 2012 (n = 1525) in the Dominican Republic, HIV biological and behavioral surveys were conducted among female sex workers (FSW) in four provinces using respondent driven sampling. Participants were ≥15 years who engaged in intercourse in exchange for money in the past 6 months and living/working in the study province. There were no statistically significant changes in HIV and other infections prevalence from 2008 to 2012, despite ongoing risky sexual practices. HIV testing and receiving results was low in all provinces. FSW in 2012 were more likely to receive HIV testing and results if they participated in HIV related information and education and had regular checkups at health centers. Further investigation is needed to understand barriers to HIV testing and access to prevention services. |
The eco-epidemiology of Pacific Coast tick fever in California
Padgett KA , Bonilla D , Eremeeva ME , Glaser C , Lane RS , Porse CC , Castro MB , Messenger S , Espinosa A , Hacker J , Kjemtrup A , Ryan B , Scott JJ , Hu R , Yoshimizu MH , Dasch GA , Kramer V . PLoS Negl Trop Dis 2016 10 (10) e0005020 Rickettsia philipii (type strain "Rickettsia 364D"), the etiologic agent of Pacific Coast tick fever (PCTF), is transmitted to people by the Pacific Coast tick, Dermacentor occidentalis. Following the first confirmed human case of PCTF in 2008, 13 additional human cases have been reported in California, more than half of which were pediatric cases. The most common features of PCTF are the presence of at least one necrotic lesion known as an eschar (100%), fever (85%), and headache (79%); four case-patients required hospitalization and four had multiple eschars. Findings presented here implicate the nymphal or larval stages of D. occidentalis as the primary vectors of R. philipii to people. Peak transmission risk from ticks to people occurs in late summer. Rickettsia philipii DNA was detected in D. occidentalis ticks from 15 of 37 California counties. Similarly, non-pathogenic Rickettsia rhipicephali DNA was detected in D. occidentalis in 29 of 38 counties with an average prevalence of 12.0% in adult ticks. In total, 5,601 ticks tested from 2009 through 2015 yielded an overall R. philipii infection prevalence of 2.1% in adults, 0.9% in nymphs and a minimum infection prevalence of 0.4% in larval pools. Although most human cases of PCTF have been reported from northern California, acarological surveillance suggests that R. philipii may occur throughout the distribution range of D. occidentalis. |
Rubella persistence in epidermal keratinocytes and granuloma M2 macrophages in patients with primary immunodeficiencies
Perelygina L , Plotkin S , Russo P , Hautala T , Bonilla F , Ochs HD , Joshi A , Routes J , Patel K , Wehr C , Icenogle J , Sullivan KE . J Allergy Clin Immunol 2016 138 (5) 1436-1439 e11 Cutaneous granulomas are a well-recognized pathologic feature in patients with various primary immunodeficiency diseases (PIDs) and may be self-limited or can progress to a persisting granulomatous disorder.1,2 Rubella virus (RV) vaccine strain RA27/3 has been recently detected in disseminated cutaneous granulomas of 2 patients with ataxia telangiectasia (AT) and a patient with Simpson-Golabi-Behmel syndrome (who had combined immunodeficiency [CID]).3 However, a more detailed study of a larger series of granuloma cases in patients with different PIDs was required to confirm and extend this observation. | Patients with cutaneous granulomas and with diverse PIDs were selected from the United States Immune Deficiency Network registry. Additional cases (cases 1 and 11) were recruited from the Clinical Immunology Society immune deficiency Listserv. Presence of RV in granuloma-containing tissue samples (Fig 1, A–C) was examined by immunofluorescence staining with 2 different RV capsid-specific antibodies (see this article’s Methods section in the Online Repository at www.jacionline.org) by a reader blinded to the diagnosis. Seven out of 14 patients (50%) exhibited positive RV antigen staining (Table I), whereas the tissue samples of 5 non-PID granuloma patients were negative. |
Impact of HIV on mortality among patients treated for tuberculosis in Lima, Peru: a prospective cohort study
Velasquez GE , Cegielski JP , Murray MB , Yagui MJ , Asencios LL , Bayona JN , Bonilla CA , Jave HO , Yale G , Suarez CZ , Sanchez E , Rojas C , Atwood SS , Contreras CC , Cruz JS , Shin SS . BMC Infect Dis 2016 16 (1) 45 BACKGROUND: Human immunodeficiency virus (HIV)-associated tuberculosis deaths have decreased worldwide over the past decade. We sought to evaluate the effect of HIV status on tuberculosis mortality among patients undergoing treatment for tuberculosis in Lima, Peru, a low HIV prevalence setting. METHODS: We conducted a prospective cohort study of patients treated for tuberculosis between 2005 and 2008 in two adjacent health regions in Lima, Peru (Lima Ciudad and Lima Este). We constructed a multivariate Cox proportional hazards model to evaluate the effect of HIV status on mortality during tuberculosis treatment. RESULTS: Of 1701 participants treated for tuberculosis, 136 (8.0 %) died during tuberculosis treatment. HIV-positive patients constituted 11.0 % of the cohort and contributed to 34.6 % of all deaths. HIV-positive patients were significantly more likely to die (25.1 vs. 5.9 %, P < 0.001) and less likely to be cured (28.3 vs. 39.4 %, P = 0.003). On multivariate analysis, positive HIV status (hazard ratio [HR] = 6.06; 95 % confidence interval [CI], 3.96-9.27), unemployment (HR = 2.24; 95 % CI, 1.55-3.25), and sputum acid-fast bacilli smear positivity (HR = 1.91; 95 % CI, 1.10-3.31) were significantly associated with a higher hazard of death. CONCLUSIONS: We demonstrate that positive HIV status was a strong predictor of mortality among patients treated for tuberculosis in the early years after Peru started providing free antiretroviral therapy. As HIV diagnosis and antiretroviral therapy provision are more widely implemented for tuberculosis patients in Peru, future operational research should document the changing profile of HIV-associated tuberculosis mortality. |
Demographic and clinical characteristics of deaths associated with influenza A(H1N1) pdm09 in Central America and Dominican Republic 2009-2010
Chacon R , Mirza S , Rodriguez D , Paredes A , Guzman G , Moreno L , Then CJ , Jara J , Blanco N , Bonilla L , Clara WA , Minaya P , Palekar R , Azziz-Baumgartner E . BMC Public Health 2015 15 (1) 734 BACKGROUND: The demographic characteristics of pandemic influenza decedents among middle and low-income tropical countries are poorly understood. We explored the demographics of persons who died with influenza A (H1N1)pdm09 infection during 2009-2010, in seven countries in the American tropics. METHODS: We used hospital-based surveillance to identify laboratory-confirmed influenza deaths in Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama and Dominican Republic. An influenza death was defined as a person who died within two weeks of a severe acute respiratory infection (SARI) defined as sudden onset of fever >38 degrees C, cough or sore-throat, and shortness of breath, or difficulty breathing requiring hospitalization, and who tested positive for influenza A (H1N1)pdm09 virus by real time polymerase chain reaction. We abstracted the demographic and clinical characteristics of the deceased from their medical records. RESULTS: During May 2009-June 2010, we identified 183 influenza deaths. Their median age was 32 years (IQR 18-46 years). One-hundred and one (55 %) were female of which 20 (20 %) were pregnant and 7 (7 %) were in postpartum. One-hundred and twelve decedents (61 %) had pre-existing medical conditions, (15 % had obesity, 13 % diabetes, 11 % asthma, 8 % metabolic disorders, 5 % chronic obstructive pulmonary disease, and 10 % neurological disorders). 65 % received oseltamivir but only 5 % received it within 48 h of symptoms onset. CONCLUSIONS: The pandemic killed young adults, pregnant women and those with pre-existing medical conditions. Most sought care too late to fully benefit from oseltamivir. We recommend countries review antiviral treatment policies for people at high risk of developing complications. |
Risk factors for human lice and Bartonellosis among the homeless, San Francisco, California, USA
Bonilla DL , Cole-Porse C , Kjemtrup A , Osikowicz L , Kosoy M . Emerg Infect Dis 2014 20 (10) 1645-51 Homeless persons in San Francisco, California, USA, have been shown to have head and body lice infestations and Bartonella quintana infections. We surveyed a self-selected population of homeless persons in San Francisco to assess infestations of head and body lice, risks of having body lice, and presence of B. quintana in lice. A total of 203 persons who reported itching were surveyed during 2008-2010 and 2012: 60 (30%) had body lice, 10 (4.9%) had head lice, and 6 (3.0%) had both. B. quintana was detected in 10 (15.9%) of 63 body lice pools and in 6 (37.5%) of 16 head lice pools. Variables significantly associated (p<0.05) with having body lice in this homeless population included male sex, African-American ethnicity, and sleeping outdoors. Our study findings suggest that specific segments of the homeless population would benefit from information on preventing body lice infestations and louse-borne diseases. |
Clinical characteristics, drug resistance, and treatment outcomes among tuberculosis patients with diabetes in Peru
Magee MJ , Bloss E , Shin SS , Contreras C , Huaman HA , Ticona JC , Bayona J , Bonilla C , Yagui M , Jave O , Cegielski JP . Int J Infect Dis 2013 17 (6) e404-12 OBJECTIVES: Diabetes is a risk factor for active tuberculosis (TB). Data are limited regarding the association between diabetes and TB drug resistance and treatment outcomes. We examined characteristics of TB patients with and without diabetes in a Peruvian cohort at high risk for drug-resistant TB. Among TB patients with diabetes (TB-DM), we studied the association between diabetes clinical/management characteristics and TB drug resistance and treatment outcomes. METHODS: During 2005-2008, adults with suspected TB with respiratory symptoms in Lima, Peru, who received rapid drug susceptibility testing (DST), were prospectively enrolled and followed during treatment. Bivariate and Kaplan-Meier analyses were used to examine the relationships of diabetes characteristics with drug-resistant TB and TB outcomes. RESULTS: Of 1671 adult TB patients enrolled, 186 (11.1%) had diabetes. TB-DM patients were significantly more likely than TB patients without diabetes to be older, have had no previous TB treatment, and to have a body mass index (BMI) >18.5kg/m(2) (p<0.05). In patients without and with previous TB treatment, the prevalence of multidrug-resistant TB was 23% and 26%, respectively, among patients without diabetes, and 12% and 28%, respectively, among TB-DM patients. Among 149 TB-DM patients with DST results, 104 (69.8%) had drug-susceptible TB and 45 (30.2%) had drug-resistant TB, of whom 29 had multidrug-resistant TB. There was no association between diabetes characteristics and drug-resistant TB. Of 136 TB-DM patients with outcome information, 107 (78.7%) had a favorable TB outcome; active diabetes management was associated with a favorable outcome. CONCLUSIONS: Diabetes was common in a cohort of TB patients at high risk for drug-resistant TB. Despite prevalent multidrug-resistant TB among TB-DM patients, the majority had a favorable TB treatment outcome. |
Impact of rapid drug susceptibility testing for tuberculosis: program experience in Lima, Peru
Shin SS , Asencios L , Yagui M , Yale G , Suarez C , Bayona J , Bonilla C , Jave O , Contreras CC , Atwood S , Blaya JA , Ershova J , Cegielski JP . Int J Tuberc Lung Dis 2012 16 (11) 1538-43 SETTING: Programmatic implementation of decentralized rapid drug susceptibility testing (DST) in Lima, Peru. OBJECTIVE: Pre-post analysis compared time to diagnosis, treatment outcome and survival among patients tested with direct nitrate reductase assay (NRA) vs. indirect conventional methods. DESIGN: From 2005 to 2009, we prospectively followed all patients referred for DST before (control) and after (intervention) NRA implementation. Among those referred for DST, NRA was used for smear-positive samples of patients with no prior history of multidrug resistance or treatment for multidrug-resistant tuberculosis (TB). Data were abstracted from patient charts and laboratory registers. Endpoints were favorable outcomes, time to result and time to death. RESULTS: Of those patients who met the criteria for NRA, 740 underwent NRA and 621 underwent conventional DST. NRA yielded test results for 78.4% of cases vs. 68.8% for conventional DST (P < 0.0001); the median time to result was 44 vs. 133 days, respectively (adjusted HR 0.64, 95%CI 0.56-0.73). Among individuals without previous anti-tuberculosis treatment, NRA was associated with a favorable treatment outcome (adjusted OR 1.39, 95%CI 1.01-1.90) and prolonged survival (adjusted HR 0.53, 95%CI 0.31-0.90). CONCLUSION: Direct NRA significantly shortened time to test result and improved treatment outcomes and survival in certain groups. |
Estimated incidence of influenza-virus-associated severe pneumonia in children in El Salvador, 2008-2010
Clara W , Armero J , Rodriguez D , de Lozano C , Bonilla L , Minaya P , Chacon R , Jara J , Blanco N , Widdowson MA , Bresee J , Xu X , Klimov A , Azziz-Baumgartner E , Linares-Perez N . Bull World Health Organ 2012 90 (10) 756-763 OBJECTIVE: To estimate the incidence of influenza-virus-associated severe pneumonia among Salvadorian children aged < 5 years. METHODS: Data on children aged < 5 years admitted with severe pneumonia to a sentinel hospital in the western region were collected weekly. Nasal and oropharyngeal swab specimens were collected from a convenience sample of case patients for respiratory virus testing. A health-care utilization survey was conducted in the hospital catchment area to determine the proportion of residents who sought care at the hospital. The incidence of influenza-virus-associated severe pneumonia among all Salvadorian children aged < 5 years was estimated from surveillance and census data, with adjustment for health-care utilization. Influenza virus strains were characterized by the United States Centers for Disease Control and Prevention to determine their correspondence with northern and southern hemisphere influenza vaccine formulations. FINDINGS: Physicians identified 2554 cases of severe pneumonia. Samples from 608 cases were tested for respiratory viruses and 37 (6%) were positive for influenza virus. The estimated incidence of influenza-virus-associated severe pneumonia was 3.2 cases per 1000 person-years (95% confidence interval, CI: 2.8-3.7) overall, 1.5 cases per 1000 person-years (95% CI: 1.0-2.0) during 2008, 7.6 cases per 1000 person-years (95% CI: 6.5-8.9) during 2009 and 0.6 cases per 1000 person-years (95% CI: 0.3-1.0) during 2010. Northern and southern hemisphere vaccine formulations matched influenza virus strains isolated during 2008 and 2010. CONCLUSION: Influenza-virus-associated severe pneumonia occurred frequently among young Salvadorian children during 2008-2010. Antigens in northern and southern hemisphere influenza vaccine formulations corresponded to circulating strains. |
Concordance of programmatic and laboratory-based multidrug-resistant tuberculosis treatment outcomes in Peru
Alexy ER , Podewils LJ , Mitnick CD , Becerra MC , Laserson KF , Bonilla C . Int J Tuberc Lung Dis 2012 16 (3) 364-369 BACKGROUND: Confirmation of cure for multidrugresistant tuberculosis (MDR-TB) patients requires laboratory tests for Mycobacterium tuberculosis growth on culture media. Outcome decisions dictate patient management, and inaccuracies place patients at an increased risk of morbidity and mortality, and may contribute to continued transmission of MDR-TB. OBJECTIVE: To examine concordance between programmatic and laboratory-based MDR-TB treatment outcomes. METHODS: The study population included 1658 MDRTB patients in Peru treated between 1996 and 2002 with both program and laboratory-based outcomes. Laboratory-based outcomes were assigned according to international standards requiring at least five consecutive negative cultures in the last 12 months of treatment to confirm cure. RESULTS: Compared to the global culture-defined standard classification, only 1.1% of treatment successes, but 54.3% of failures, were misclassified programmatically. Overall, 10.4% of patients identified by a clinician as having a successful treatment outcome still had cultures positive for MDR-TB. CONCLUSION: Most patients with successful treatment outcomes by strict culture definitions were also classified by clinicians as having successful outcomes. However, many culture-confirmed failures were missed. In light of delays and incomplete access to culture in MDR-TB programs, efforts should be made to improve the accuracy of programmatically determined treatment outcomes. (2012 The Union.) |
Bacteriologic monitoring of multidrug-resistant tuberculosis patients in five DOTS-Plus pilot projects
Gammino VM , Taylor AB , Rich ML , Bayona J , Becerra MC , Bonilla C , Gelmanova I , Hollo V , Jaramillo E , Keshavjee S , Leimane V , Mitnick CD , Quelapio MID , Riektsina V , Tupasi TE , Wells CD , Zignol M , Cegielski PJ . Int J Tuberc Lung Dis 2011 15 (10) 1315-1322 BACKGROUND: Multidrug-resistant tuberculosis programs in DOTS-Plus pilot sites in five countries. OBJECTIVES: To calculate sputum conversion time and its relationship to treatment outcome, document the frequency of culture reversions and examine concordance of smear and culture to assess the potential consequences of monitoring by smear microscopy alone. DESIGN: Retrospective cohort analysis of 1926 patients receiving individualized, second-line therapy. RESULTS: Among 1385 sputum culture-positive cases at baseline, 1146 (83%) experienced at least one culture conversion during treatment. Conversion, however, was not sustained in all patients: 201 (15%) experienced initial culture conversion and at least one subsequent culture reversion to positive; 1064 (77%) achieved sustainedculture conversion. Median time to culture conversion was 3 months. Among 206 patients whose final conversion occurred 7-18 months after the initiation of therapy, 71% were cured or had completed treatment. CONCLUSIONS: Prolonged treatment for patients with delayed conversion may be beneficial, as 71% of late converters still achieved cure or completed treatment. This has implications for programs with defined end points for treatment failure. The interval between first and final conversion among patients whose initial conversion is not sustained raises concern with respect to the ongoing debate regarding duration of treatment and the definition of cure. 2011 The Union. |
Targeted drug-resistance testing strategy for multidrug-resistant tuberculosis detection, Lima, Peru, 2005-2008
Velasquez GE , Yagui M , Cegielski JP , Asencios L , Bayona J , Bonilla C , Jave HO , Yale G , Susrez C , Atwood S , Contreras CC , Shin SS . Emerg Infect Dis 2011 17 (3) 432-440 The Peruvian National Tuberculosis Control Program issued guidelines in 2006 specifying criteria for culture and drug-susceptibility testing (DST), including district-level rapid DST. All patients referred for culture and DST in 2 districts of Lima, Peru, during January 2005-November 2008 were monitored prospectively. Of 1,846 patients, 1,241 (67.2%) had complete DST results for isoniazid and rifampin; 419 (33.8%) patients had multidrug-resistant (MDR) TB at the time of referral. Among patients with new smear-positive TB, household contact and suspected category I failure were associated with MDR TB, compared with concurrent regional surveillance data. Among previously treated patients with smear-positive TB, adult household contact, suspected category II failure, early relapse after category I, and multiple previous TB treatments were associated with MDR TB, compared with concurrent regional surveillance data. The proportion of MDR TB detected by using guidelines was higher than that detected by a concurrent national drug-resistance survey, indicating that the strategy effectively identified patients for DST. |
West Nile virus activity in mosquitoes and domestic animals in Chiapas, Mexico
Ulloa A , Ferguson HH , Mendez-Sanchez JD , Danis-Lozano R , Casas-Martinez M , Bond JG , Garcia-Zebadua JC , Orozco-Bonilla A , Juarez-Ordaz JA , Farfan-Ale JA , Garcia-Rejon JE , Rosado-Paredes EP , Edwards E , Komar N , Hassan HK , Unnasch TR , Rodriguez-Perez MA . Vector Borne Zoonotic Dis 2009 9 (5) 555-60 Prior to 2006, West Nile virus (WNV) had not been definitively detected in Chiapas, the southernmost state of Mexico, although it circulates elsewhere in Mexico and Central America. We collected over 30,000 mosquitoes and blood-sampled 351 domestic animals in Chiapas in search for evidence of current or recent transmission of WNV. Two mosquito pools tested positive for WNV RNA and 17 domestic animals tested positive for specific WNV-neutralizing antibodies, including young animals (<1 year old) in four of five sampled locations. The two WNV-positive mosquito pools were collected on the Pacific coastal plain of Chiapas in June, 2006, and included a pool of Culex nigripalpus, a suspected vector of WNV, and a pool of Cx. interrogator. The sequence of a 537-nucleotide portion of a cDNA amplicon derived from the WNV NS5 gene from the Cx. interrogator pool contained a single silent nucleotide substitution when compared to WNV strain NY99. |
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