Last data update: May 06, 2024. (Total: 46732 publications since 2009)
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Immune response kinetics to SARS-CoV-2 infection and COVID-19 vaccination among nursing home residents-Georgia, October 2020-July 2022
Chisty ZA , Li DD , Haile M , Houston H , DaSilva J , Overton R , Schuh AJ , Haynie J , Clemente J , Branch AG , Arons MM , Tsang CA , Pellegrini GJ Jr , Bugrysheva J , Ilutsik J , Mohelsky R , Comer P , Hundia SB , Oh H , Stuckey MJ , Bohannon CD , Rasheed MAU , Epperson M , Thornburg NJ , McDonald LC , Brown AC , Kutty PK . PLoS One 2024 19 (4) e0301367 BACKGROUND: Understanding the immune response kinetics to SARS-CoV-2 infection and COVID-19 vaccination is important in nursing home (NH) residents, a high-risk population. METHODS: An observational longitudinal evaluation of 37 consenting vaccinated NH residents with/without SARS-CoV-2 infection from October 2020 to July 2022 was conducted to characterize the immune response to spike protein due to infection and/or mRNA COVID-19 vaccine. Antibodies (IgG) to SARS-CoV-2 full-length spike, nucleocapsid, and receptor binding domain protein antigens were measured, and surrogate virus neutralization capacity was assessed using Meso Scale Discovery immunoassays. The participant's spike exposure status varied depending on the acquisition of infection or receipt of a vaccine dose. Longitudinal linear mixed effects modeling was used to describe trajectories based on the participant's last infection or vaccination; the primary series mRNA COVID-19 vaccine was considered two spike exposures. Mean antibody titer values from participants who developed an infection post receipt of mRNA COVID-19 vaccine were compared with those who did not. In a subset of participants (n = 15), memory B cell (MBC) S-specific IgG (%S IgG) responses were assessed using an ELISPOT assay. RESULTS: The median age of the 37 participants at enrollment was 70.5 years; 30 (81%) had prior SARS-CoV-2 infection, and 76% received Pfizer-BioNTech and 24% Moderna homologous vaccines. After an observed augmented effect with each spike exposure, a decline in the immune response, including %S IgG MBCs, was observed over time; the percent decline decreased with increasing spike exposures. Participants who developed an infection at least two weeks post-receipt of a vaccine were observed to have lower humoral antibody levels than those who did not develop an infection post-receipt. CONCLUSIONS: These findings suggest that understanding the durability of immune responses in this vulnerable NH population can help inform public health policy regarding the timing of booster vaccinations as new variants display immune escape. |
Organochlorine pesticides and risk of papillary thyroid cancer in U.S. military personnel: a nested case-control study
Rusiecki JA , McAdam J , Denic-Roberts H , Sjodin A , Davis M , Jones R , Hoang TD , Ward MH , Ma S , Zhang Y . Environ Health 2024 23 (1) 28 BACKGROUND: The effects of organochlorine pesticide (OCP) exposure on the development of human papillary thyroid cancer (PTC) are not well understood. A nested case-control study was conducted with data from the U.S. Department of Defense Serum Repository (DoDSR) cohort between 2000 and 2013 to assess associations of individual OCPs serum concentrations with PTC risk. METHODS: This study included 742 histologically confirmed PTC cases (341 females, 401 males) and 742 individually-matched controls with pre-diagnostic serum samples selected from the DoDSR. Associations between categories of lipid-corrected serum concentrations of seven OCPs and PTC risk were evaluated for classical PTC and follicular PTC using conditional logistic regression, adjusted for body mass index category and military branch to compute odds ratios (OR) and 95% confidence intervals (CIs). Effect modification by sex, birth cohort, and race was examined. RESULTS: There was no evidence of associations between most of the OCPs and PTC, overall or stratified by histological subtype. Overall, there was no evidence of an association between hexachlorobenzene (HCB) and PTC, but stratified by histological subtype HCB was associated with significantly increased risk of classical PTC (third tertile above the limit of detection (LOD) vs. <LOD, OR = 1.61, 95% CI, 1.09, 2.38; p for trend = 0.05) and significantly decreased risk of follicular variant PTC (third tertile above the limit of detection (LOD) vs. <LOD, OR = 0.38, 95% CI, 0.16, 0.91; p for trend = 0.04). Further stratified by sex, risk of classical PTC was higher for females (third tertile above LOD vs. <LOD, OR = 2.23, 95% CI: 1.23, 4.06; p-trend = 0.02) than for males (OR = 1.22, 95%CI: 0.72-2.08; p-trend = 0.56), though the test for interaction by sex was not statistically significant (p-interaction = 0.30). Similarly, β-hexachlorocyclohexane (β-HCCH) was associated with a higher risk for classical PTC for women with concentrations ≥LOD versus <LOD (OR = 1.76, 95% CI: 1.07, 2.89), while the effects were null for men. There were no consistent trends when stratified by race or birth year. CONCLUSIONS: The U.S. Environmental Protection Agency has classified HCB and other OCPs we studied here as probable human carcinogens. Our findings of increased risks for classical PTC associated with increased concentrations of HCB and β-HCCH, which were stronger among females, should be replicated in future studies of other populations. |
Endocrine disrupting chemical mixture exposure and risk of papillary thyroid cancer in U.S. military personnel: A nested case-control study
Denic-Roberts H , McAdam J , Sjodin A , Davis M , Jones R , Ward MH , Hoang TD , Ma S , Zhang Y , Rusiecki JA . Sci Total Environ 2024 922 171342 Single-pollutant methods to evaluate associations between endocrine disrupting chemicals (EDCs) and thyroid cancer risk may not reflect realistic human exposures. Therefore, we evaluated associations between exposure to a mixture of 18 EDCs, including polychlorinated biphenyls (PCBs), brominated flame retardants, and organochlorine pesticides, and risk of papillary thyroid cancer (PTC), the most common thyroid cancer histological subtype. We conducted a nested case-control study among U.S. military servicemembers of 652 histologically-confirmed PTC cases diagnosed between 2000 and 2013 and 652 controls, matched on birth year, sex, race/ethnicity, military component (active duty/reserve), and serum sample timing. We estimated mixture odds ratios (OR), 95% confidence intervals (95% CI), and standard errors (SE) for associations between pre-diagnostic serum EDC mixture concentrations, overall PTC risk, and risk of histological subtypes of PTC (classical, follicular), adjusted for body mass index and military branch, using quantile g-computation. Additionally, we identified relative contributions of individual mixture components to PTC risk, represented by positive and negative weights (w). A one-quartile increase in the serum mixture concentration was associated with a non-statistically significant increase in overall PTC risk (OR = 1.19; 95% CI = 0.91, 1.56; SE = 0.14). Stratified by histological subtype and race (White, Black), a one-quartile increase in the mixture was associated with increased classical PTC risk among those of White race (OR = 1.59; 95% CI = 1.06, 2.40; SE = 0.21), but not of Black race (OR = 0.95; 95% CI = 0.34, 2.68; SE = 0.53). PCBs 180, 199, and 118 had the greatest positive weights driving this association among those of White race (w = 0.312, 0.255, and 0.119, respectively). Findings suggest that exposure to an EDC mixture may be associated with increased classical PTC risk. These findings warrant further investigation in other study populations to better understand PTC risk by histological subtype and race. |
Marburgvirus resurgence in Kitaka Mine bat population after extermination attempts, Uganda.
Amman BR , Nyakarahuka L , McElroy AK , Dodd KA , Sealy TK , Schuh AJ , Shoemaker TR , Balinandi S , Atimnedi P , Kaboyo W , Nichol ST , Towner JS . Emerg Infect Dis 2014 20 (10) 1761-4 Marburg virus (MARV) and Ravn virus (RAVV), collectively called marburgviruses, cause Marburg hemorrhagic fever (MHF) in humans. In July 2007, 4 cases of MHF (1 fatal) occurred in miners at Kitaka Mine in southern Uganda. Later, MHF occurred in 2 tourists who visited Python Cave, ≈50 km from Kitaka Mine. One of the tourists was from the United States (December 2007) and 1 was from the Netherlands (July 2008); 1 case was fatal (1,2,3). The cave and the mine each contained 40,000–100,000 Rousettus aegyptiacus bats (Egyptian fruit bats). | | Longitudinal investigations of the outbreaks at both locations were initiated by the Viral Special Pathogens Branch of the Centers for Disease Control and Prevention (CDC, Atlanta, GA, USA, and Entebbe, Uganda) in collaboration with the Uganda Wildlife Authority (UWA) and the Uganda Virus Research Institute (UVRI). During these studies, genetically diverse MARVs and RAVVs were isolated directly from bat tissues, and infection levels of the 2 viruses were found to increase in juvenile bats on a predictable bi-annual basis (4,5). However, investigations at Kitaka Mine were stopped when the miners exterminated the bat colony by restricting egress from the cave with papyrus reed barriers and then entangling the bats in fishing nets draped over the exits. The trapping continued for weeks, and the entrances were then sealed with sticks and plastic. These depopulation efforts were documented by researchers from UVRI, the CDC, the National Institute of Communicable Diseases (Sandringham, South Africa), and UWA during site visits to Kitaka Mine (Technical Appendix Figure). In August 2008, thousands of dead bats were found piled in the forest, and by November 2008, there was no evidence of bats living in the mine; whether 100% extermination was achieved is unknown. CDC, UVRI, and UWA recommended against extermination, believing that any results would be temporary and that such efforts could exacerbate the problem if bat exclusion methods were not complete and permanent (6,7). |
The sixth vital sign: what reproduction tells us about overall health. Proceedings from a NICHD/CDC workshop.
Cedars MI , Taymans SE , DePaolo LV , Warner L , Moss SB , Eisenberg ML . Hum Reprod Open 2017 2017 (2) hox008 STUDY QUESTION: Does the fertility status of an individual act as a biomarker for their future health? SUMMARY ANSWER: Data support an association between reproductive health and overall health for men and women. WHAT IS ALREADY KNOWN: Various chronic conditions, such as diabetes, obesity and cancer, can compromise fertility, but there are limited data for the converse situation, in which fertility status can influence or act as a marker for future health. Data reveal an association between infertility and incident cardiovascular disease and cancer in both men and women. STUDY DESIGN SIZE AND DURATION: A National Institute of Child Health and Human Development-Centers for Disease Control and Prevention workshop in April 2016 was convened that brought together experts in both somatic diseases and conditions, and reproductive health. Goals of the workshop included obtaining information about the current state of the science linking fertility status and overall health, identifying potential gaps and barriers limiting progress in the field, and outlining the highest priorities to move the field forward. PARTICIPANTS/MATERIALS SETTING AND METHODS: Approximately 40 experts participated in the workshop. MAIN RESULTS AND THE ROLE OF CHANCE: While the etiology remains uncertain for infertility, there is evidence for an association between male and female infertility and later health. The current body of evidence suggests four main categories for considering biological explanations: genetic factors, hormonal factors, in utero factors, and lifestyle/health factors. These categories would be key to include in future studies to develop a comprehensive and possibly standardized look at fertility status and overall health. Several themes emerged from the group discussion including strategies for maximizing use of existing resources and databases, the need for additional epidemiologic studies and public health surveillance, development of strategies to frame research so results could ultimately influence clinical practice, and the identification of short and long-term goals and the best means to achieve them. LIMITATIONS REASONS FOR CAUTION: Further research may not indicate an association between fertility status and overall health. WIDER IMPLICATIONS OF THE FINDINGS: Currently medical care is compartmentalized. Reproductive medicine physicians treat patients for a short period of time before they transition to others for future care. Going forward, it is critical to take an interdisciplinary patient care approach that would involve experts in a broad range of medical specialties in order to more fully understand the complex interrelationships between fertility and overall health. If infertility is confirmed as an early marker of chronic disease then screening practices could be adjusted, as they are for patients with a family history of malignancy. STUDY FUNDING/COMPETING INTERESTS: Funding for the workshop was provided by the Fertility and Infertility Branch, National Institute of Child Health and Human Development, National Institutes of Health and the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control. There are no conflicts of interest to declare. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the National Institutes of Health. TRIAL REGISTRATION NUMBER: Not applicable. |
Rabies experts on demand: A cross-sectional study describing the use of a rabies telehealth service
Baker SE , Ross YB , Ellison JA , Monroe BP , Orciari LA , Petersen BW , Rao AK , Wallace RM . Public Health Chall 2023 2 (3) BACKGROUND: Rabies expert on demand (REOD) telehealth service is provided by the U.S. Centers for Disease Control and Prevention (CDC) to assist public health practitioners, health providers, and the public to interpret national and international rabies prevention guidelines. REOD is staffed by subject matter experts of the CDC Poxvirus and Rabies Branch to assess each unique situation and provide evidence-based guidance to stakeholders. This study aims to describe the utilization of a rabies telehealth system and provide insight into common consultations. METHODS: A cross-sectional study of the nature of inquiries to REOD was done using the data collected from September 1, 2017 to September 30, 2021. An inquiry tracking form and Microsoft Access database were developed to document all inquiries received. Inquired ones were summarized to determine the frequency of inquiries by month, category, and location. RESULTS: Over a 49-month period, REOD received 5228 inquiries. Peak inquiries (n = 108) occurred during August 2019. The most frequent inquiries received pertained to risk assessment and management of rabies exposures (n = 1109), requests for testing assistance (n = 912), consultation for suspected human rabies (n = 746), rabies exposures and post-bite treatment occurring internationally (n = 310), and consultation for deviations in the recommended pre- and postexposure prophylaxis regimen (n = 300). CONCLUSION: REOD is a global resource for consultation related to managing rabies exposures, diagnostic issues, and rabies control strategies. REOD is a regularly utilized CDC service, as the demand for up-to-date rabies guidance remains high. REOD fulfills a critical role for the interpretation and consultation on rabies prevention guidelines to stakeholder. |
Community-based surveys for Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions in selected regions of mainland Tanzania (preprint)
Bakari C , Jones S , Subramaniam G , Mandara CI , Chiduo MG , Rumisha S , Chacky F , Molteni F , Mandike R , Mkude S , Njau R , Herman C , Nace DP , Mohamed A , Udhayakumar V , Kibet CK , Nyanjom SG , Rogier E , Ishengoma DS . medRxiv 2020 2020.05.12.20097766 Background Despite recent reports of false negative results among histidine-rich protein 2 (HRP2) based-malaria rapid diagnostic tests (mRDTs) caused by pfhrp2/3 gene deletions in different countries, there is paucity of data in Tanzania.Methods This study assessed the status of pfhrp2/3 deletions in 7,543 blood samples using laboratory multiplex antigen detection (Plasmodium lactate dehydrogenase - pLDH, aldolase, and HRP2). Samples showing mRDT false negativity or aberrant relationship of HRP2 to pan-Plasmodium antigens were genotyped for pfhrp2/3genes.Results Of all samples, 2,417 (32.0%) were positive for any Plasmodium antigens while 5,126 (68.0%) were negative. About 99.8% (n=2,411) of antigen positive samples had HRP2, but 6 (0.2%) had only pLDH and/or pAldolase. Thirteen samples had atypical relationships between pan-Plasmodium antigens and HRP2, but were positive by PCR. An additional 16 samples with negative HRP2 mRDTs but positive by microscopy were also chosen; all giving 35 samples genotyped for pfhrp2/3. Of 35 samples, 4 (11.4%) failed to consistently amplify positive control genes (pfmsp1 and pfmsp2), and pfhrp2 and pfhrp3 genes were successfully amplified in 31 (88.6%) samples.Conclusions Lack of pfhrp2 and/or pfhrp3 genes deletions in Plasmodium falciparum parasites supports continued use of HRP2-based mRDTs for routine malaria diagnosis in Tanzania.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThe field component of this study was supported by The Global Fund through National Malaria Control Programme of the Tanzanian Ministry of Health. The CDC laboratory work was supported by Malaria Branch and Catherine Bakari’s MSc studies was funded by the Developing Excellence in Leadership and Genomics for Malaria Elimination (DELGEME) project with funding from the Developing Excellence in Leadership and Training (DELTAS) Africa Initiative, of the African Academy of Sciences (AAS).Author DeclarationsAll relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript.YesAll necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request |
Novel pneumococcal capsule type 33E results from the inactivation of glycosyltransferase WciE in vaccine type 33F
Ganaie FA , Saad JS , Lo SW , McGee L , van Tonder AJ , Hawkins PA , Calix JJ , Bentley SD , Nahm MH . J Biol Chem 2023 299 (9) 105085 The polysaccharide (PS) capsule is essential for immune evasion and virulence of Streptococcus pneumoniae. Existing pneumococcal vaccines are designed to elicit anti-capsule antibodies, however, the effectiveness of these vaccines is being challenged by the emergence of new capsule types or variants. Herein, we characterize a newly discovered capsule type, 33E, that appears to have repeatedly emerged from vaccine type 33F via an inactivation mutation in the capsule glycosyltransferase gene, wciE. Structural analysis demonstrated that 33E and 33F share an identical repeat unit backbone [→5)-β-D-Galf2Ac-(1→3)-β-D-Galp-(1→3)-α-D-Galp-(1→3)-β-D-Galf-(1→3)-β-D-Glcp-(1→], except that a galactose (α-D-Galp) branch is present in 33F but not in 33E. Though the two capsule types were indistinguishable using conventional typing methods, the monoclonal antibody Hyp33FM1 selectively bound 33F but not 33E pneumococci. Further, we confirmed that wciE encodes a glycosyltransferase that catalyzes the addition of the branching α-D-Galp and that its inactivation in 33F strains results in the expression of the 33E capsule type. Though 33F and 33E share a structural and antigenic similarity, our pilot study suggested that immunization with a 23-valent pneumococcal PS vaccine containing 33F PS didn't significantly elicit cross-opsonic antibodies to 33E. New conjugate vaccines that target capsule type 33F may not necessarily protect against 33E. Therefore, studies of new conjugate vaccines require knowledge of the newly identified capsule type 33E and reliable pneumococcal typing methods capable of distinguishing it from 33F. |
The use of travel as an appeal to motivate millennial parents on facebook to get vaccinated against COVID-19: A message framing evaluation
Arshanapally S , Starr T , Elsberry LB , Rinker R . JMIR Form Res 2023 7 e43720 BACKGROUND: In summer 2021, the Centers for Disease Control and Prevention (CDC) recommended that people get fully vaccinated against COVID-19 before fall travel to protect themselves and others from getting and spreading COVID-19 and new variants. Only 61% of parents had reported receiving at least one dose of the COVID-19 vaccine, according to a Kaiser Family Foundation study. Millennial parents, ages 25 to 40, were a particularly important parent population because they were likely to have children under 12 (the age cutoff for COVID-19 vaccine eligibility during this time period) and were still planning to travel. Since Facebook has been identified as a popular platform for Millennials and parents, CDC's Travelers' Health Branch determined an evaluation of public health messages was needed to identify which message appeals would resonate best with this population on Facebook. OBJECTIVE: The objective was to evaluate which travel-based public health message appeals aimed at addressing parental concerns and sentiments about COVID-19 vaccination would resonate most with Millennial parents (25 to 40 years old) using Facebook Ads Manager and social media metrics. METHODS: Six travel-based public health message appeals on parental concerns and sentiments around COVID-19 were developed and disseminated to Millennial parents using Facebook Ads Manager. The messages ran from October 23, 2021, to November 8, 2021. Primary outcomes included the number of people reached and the number of impressions delivered. Secondary outcomes included engagements, clicks, click-through rate (CTR), and audience sentiments. A thematic analysis was conducted to analyze comments. The advertisement budget was evaluated by cost-per-mille (CPM) and cost-per-click (CPC) metrics. RESULTS: All messages reached a total of 6,619,882 people and garnered 7,748,375 impressions. The Family (n=3,572,140 people reached [53.96%]; 4,515,836 impressions [58.28%]) and Return to Normalcy (n=1,639,476 people reached [24.77%]; 1,754,227 impressions [22.64%]) message appeals reached the greatest number of people and garnered the most impressions out of all six message appeals. The Family message appeal received 3,255 engagements (60.46%) and the Return to Normalcy message appeal received 1,148 engagements (21.28%). The Family appeal also received the highest number of positive post reactions (n=82, 28.37%). Most of the comments portrayed negative opinions about COVID-19 vaccination (n=46, 68.66%). All 6 message appeals, including the Family (CPM=US $3.44) and Return to Normalcy (CPM=US $3.47) appeals, were either on par with or outperformed CPM benchmarks set by other similar public health campaigns. CONCLUSIONS: Health communicators can use travel, specifically the Family and Return to Normalcy message appeals, to successfully reach parents in their future COVID-19 vaccination campaigns and potentially inform health communication messaging efforts for other vaccine preventable infectious disease campaigns. Public health programs can also utilize the lessons learned from this evaluation to communicate important COVID-19 information to their parent populations through travel messaging. |
Epidemiologic trends of dengue in U.S. Territories, 2010-2020
Ryff KR , Rivera A , Rodriguez DM , Santiago GA , Medina FA , Ellis EM , Torres J , Pobutsky A , Munoz-Jordan J , Paz-Bailey G , Adams LE . MMWR Surveill Summ 2023 72 (4) 1-12 PROBLEM/CONDITION: Dengue is one of the most common vectorborne flaviviral infections globally, with frequent outbreaks in tropical regions. In 2019 and 2020, the Pan American Health Organization reported approximately 5.5 million dengue cases from the Americas, the highest number on record. In the United States, local dengue virus (DENV) transmission has been reported from all U.S. territories, which are characterized by tropical climates that are highly suitable for Aedes species of mosquitoes, the vector that transmits dengue. Dengue is endemic in the U.S. territories of American Samoa, Puerto Rico, and the U.S. Virgin Islands (USVI). Dengue risk in Guam and the Commonwealth of the Northern Mariana Islands is considered sporadic or uncertain. Despite all U.S. territories reporting local dengue transmission, epidemiologic trends over time have not been well described. REPORTING PERIOD: 2010-2020. DESCRIPTION OF SYSTEM: State and territorial health departments report dengue cases to CDC through ArboNET, the national arboviral surveillance system, which was developed in 2000 to monitor West Nile virus infections. Dengue became nationally notifiable in ArboNET in 2010. Dengue cases reported to ArboNET are categorized using the 2015 Council of State and Territorial Epidemiologists case definition. In addition, DENV serotyping is performed at CDC's Dengue Branch Laboratory in a subset of specimens to support identification of circulating DENV serotypes. RESULTS: During 2010-2020, a total of 30,903 dengue cases were reported from four U.S. territories to ArboNET. Puerto Rico reported the highest number of dengue cases (29,862 [96.6%]), followed by American Samoa (660 [2.1%]), USVI (353 [1.1%]), and Guam (28 [0.1%]). However, annual incidence rates were highest in American Samoa with 10.2 cases per 1,000 population in 2017, followed by Puerto Rico with 2.9 in 2010 and USVI with 1.6 in 2013. Approximately one half (50.6%) of cases occurred among persons aged <20 years. The proportion of persons with dengue who were hospitalized was high in three of the four territories: 45.5% in American Samoa, 32.6% in Puerto Rico, and 32.1% in Guam. In Puerto Rico and USVI, approximately 2% of reported cases were categorized as severe dengue. Of all dengue-associated deaths, 68 (0.2%) were reported from Puerto Rico; no deaths were reported from the other territories. During 2010-2020, DENV-1 and DENV-4 were the predominant serotypes in Puerto Rico and USVI. INTERPRETATION: U.S. territories experienced a high prevalence of dengue during 2010-2020, with approximately 30,000 cases reported, and a high incidence during outbreak years. Children and adolescents aged <20 years were disproportionately affected, highlighting the need for interventions tailored for this population. Ongoing education about dengue clinical management for health care providers in U.S. territories is important because of the high hospitalization rates reported. Dengue case surveillance and serotyping can be used to guide future control and prevention measures in these areas. PUBLIC HEALTH ACTION: The Advisory Committee on Immunization Practices recommends vaccination with Dengvaxia for children aged 9-16 years with evidence of previous dengue infection and living in areas where dengue is endemic. The recommendation for the dengue vaccine offers public health professionals and health care providers a new intervention for preventing illness and hospitalization in the age group with the highest burden of disease in the four territories (Paz Bailey G, Adams L, Wong JM, et al. Dengue Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021. MMWR Recomm Rep 2021;70[No. RR-6]). American Samoa, Puerto Rico, and USVI are all considered endemic areas and persons residing in these areas are eligible for the new dengue vaccine. Persons aged 9-16 years in those jurisdictions with laboratory evidence of previous dengue infection can receive the dengue vaccine and benefit from a reduced risk for symptomatic disease, hospitalization, or severe dengue. Health care providers in these areas should be familiar with the eligibility criteria and recommendations for vaccination to reduce the burden of dengue among the group at highest risk for symptomatic illness. Educating health care providers about identification and management of dengue cases can improve patient outcomes and improve surveillance and reporting of dengue cases. |
Mycobacterium tuberculosis RD-Rio Strain in Kazakhstan
Skiba Y , Mokrousov I , Nabirova D , Vyazovaya A , Maltseva E , Malakhova N , Ismagulova G , Pole I , Ranka R , Sapiyeva Z , Ismailov S , Moffett D . Emerg Infect Dis 2019 25 (3) 604-606 Mycobacterium tuberculosis RD-Rio strains are still rare in the former Soviet Union countries and Asia. We describe a strain in Kazakhstan that belongs to the RD-Rio secondary branch, which is endemic to northwest Russia and eastern Europe. Although RD-Rio strains are frequently multidrug resistant, this heterogeneous branch included only drug-susceptible isolates. |
Federal Research Action Plan on Recycled Tire Crumb Used on Playing Fields: Tire Crumb Rubber Characterization and Exposure Characterization Study Overview
Benson K , Irvin-Barnwell E , Ragin-Wilson A , Breysse P . J Environ Health 2019 82 (2) 28-30 As part of our continued effort to highlight innovative approaches to improve the health and environment of communities, the Journal is pleased to publish a bimonthly column from the Agency for Toxic Substances and Disease Registry (ATSDR) at the Centers for Disease Control and Prevention (CDC). ATSDR serves the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances. The purpose of this column is to inform readers of ATSDR's activities and initiatives to better understand the relationship between exposure to hazardous substances in the environment, its impact on human health, and how to protect public health. The conclusions of this column are those of the author(s) and do not necessarily represent the official position of ATSDR or CDC. Kelsey Benson is an environmental epidemiologist at ATSDR. Elizabeth Irvin-Barnwell currently serves as the acting chief of the Environmental Epidemiology Branch at ATSDR. Angela Ragin-Wilson currently serves as the acting deputy director of the Division of Toxicology and Human Health Sciences at ATSDR. Pat Breysse is the director of CDC's National Center for Environmental Health/ATSDR. |
Insights Into the National Institute for Occupational Safety and Health's Emergency Preparedness and Response Program
Victory KR , Shugart J , Burrer S , Dowell CH , Delaney LJ . J Environ Health 2019 82 (1) 30-33 NEHA strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we feature this column on environmental health services from the Centers for Disease Control and Prevention (CDC) in every issue of the Journal. In these columns, authors from CDC's Water, Food, and Environmental Health Services Branch, as well as guest authors, will share insights and information about environmental health programs, trends, issues, and resources. The conclusions in these columns are those of the author(s) and do not necessarily represent the official position of CDC. Kerton Victory is an environmental health specialist and emergency coordinator with the National Institute for Occupational Safety and Health's (NIOSH) Emergency Preparedness and Response Office (EPRO). Jill Shugart is a senior environmental health specialist and the Emergency Responder Health Monitoring and Surveillance coordinator with NIOSH EPRO. Sherry Burrer is a senior epidemiologist and emergency coordinator with NIOSH EPRO. Chad Dowell is the NIOSH deputy associate director for emergency preparedness and response. Lisa Delaney is the NIOSH associate director for emergency preparedness and response. |
Funding and accountability in public programs: Implications for Disease Intervention Specialists (DIS)
Romaguera RA , Lakshman M . Sex Transm Dis 2023 50 S23-S27 Public health agencies are held accountable in a variety of ways: directly to funders, heads of the executive branch, and boards of health where applicable, and indirectly to the communities they serve.”1“In addition to their own accountability for discharging their statutory duties and using federal, state, and local funding appropriately, public health agencies are stewards of a community’s overall health and can play the role of monitors, conveners, or rapporteurs with respect to the performance and accomplishments of other stakeholders in the health system.”1This paper will examine various elements and types of accountabilities and provide examples of governmental and non-governmental accountability systems that are relevant to CDC-funded programs, including those supporting Disease Intervention Specialists (DIS). |
Discovery and Characterization of Pneumococcal Serogroup 36 Capsule Subtypes, Serotypes 36A and 36B.
Ganaie FA , Saad JS , Lo SW , McGee L , Bentley SD , van Tonder AJ , Hawkins P , Keenan JD , Calix JJ , Nahm MH . J Clin Microbiol 2023 61 (4) e0002423 Streptococcus pneumoniae can produce a wide breadth of antigenically diverse capsule types, a fact that poses a looming threat to the success of vaccines that target pneumococcal polysaccharide (PS) capsule. Yet, many pneumococcal capsule types remain undiscovered and/or uncharacterized. Prior sequence analysis of pneumococcal capsule synthesis (cps) loci suggested the existence of capsule subtypes among isolates identified as "serotype 36" according to conventional capsule typing methods. We discovered these subtypes represent two antigenically similar but distinguishable pneumococcal capsule serotypes, 36A and 36B. Biochemical analysis of their capsule PS structure reveals that both have the shared repeat unit backbone [→5)-α-d-Galf-(1→1)-d-Rib-ol-(5→P→6)-β-d-ManpNAc-(1→4)-β-d-Glcp-(1→] with two branching structures. Both serotypes have a β-d-Galp branch to Ribitol. Serotypes 36A and 36B differ by the presence of a α-d-Glcp-(1→3)-β-d-ManpNAc or α-d-Galp-(1→3)-β-d-ManpNAc branch, respectively. Comparison of the phylogenetically distant serogroup 9 and 36 cps loci, which all encode this distinguishing glycosidic bond, revealed that the incorporation of Glcp (in types 9N and 36A) versus Galp (in types 9A, 9V, 9L, and 36B) is associated with the identity of four amino acids in the cps-encoded glycosyltransferase WcjA. Identifying functional determinants of cps-encoded enzymes and their impact on capsule PS structure is key to improving the resolution and reliability of sequencing-based capsule typing methods and discovering novel capsule variants indistinguishable by conventional serotyping methods. |
Notes From the Field: First evidence of locally acquired dengue virus infection - Maricopa County, Arizona, November 2022
Kretschmer M , Collins J , Dale AP , Garrett B , Koski L , Zabel K , Staab RN , Turnbow K , Nativio J , Andrews K , Smith WE , Townsend J , Busser N , Will J , Burr K , Jones FK , Santiago GA , Fitzpatrick KA , Ruberto I , Fitzpatrick K , White JR , Adams L , Sunenshine RH . MMWR Morb Mortal Wkly Rep 2023 72 (11) 290-291 On November 7, 2022, dengue virus (DENV), which is not endemic in the continental United States (1), was identified in a Maricopa County, Arizona resident by reverse transcription–polymerase chain reaction (RT-PCR) testing at Arizona State Public Health Laboratory (ASPHL). The patient (patient A) was admitted to a hospital on October 19 for a dengue-like illness, 7 days after traveling to and remaining in Mexicali, Mexico for <4 hours. Patient A was hospitalized for 3 days and subsequently recovered. Maricopa County Environmental Services Department (MCESD) conducted retrospective testing for DENV in samples collected from 21 mosquito pools located within 5 miles (8 km) of patient A’s residence during October 1–November 3. A sample collected from one mosquito pool (pool A) on October 5 was positive for DENV. Whole genome sequencing by CDC’s Dengue Branch later revealed that closely related DENV-3 strains not known to be circulating in the patient’s travel region were identified in both patient A and pool A, suggesting local DENV transmission. |
Keep your water safe with resources from the Centers for Disease Control and Prevention
Curtiss E , Hils J , Rokisky JJr . J Environ Health 2022 84 (10) 42-43 People in the U.S. have access to some | of the safest public drinking water supplies in the world (Centers for Disease | Control and Prevention [CDC], 2021a). Environmental health professionals are one of | the key groups that help make drinking water safe. They also help make water safe for | communities that depend on private wells, | residents in buildings with complex water systems, and swimmers who exercise regularly in | pools. The Water, Food, and Environmental | Health Services Branch (WFEHSB) within the | Centers for Disease Control and Prevention | (CDC) supports environmental health professionals with tools and resources to strengthen | safe water for community health (Table 1) |
Engineering controls for respirable crystalline silica hazards: investigations by NIOSH's Engineering and Physical Hazards Branch
Alexander BM , Echt A , Qi C , Hammond D , Garcia A . Synergist 2022 33 (4) 20-25 Respirable crystalline silica is one of the oldest occupational hazards, yet exposures to RCS still cause illness today. Inhalation of RCS is associated with a range of serious illnesses, but it is known primarily for causing silicosis, an incurable and often fatal fibrotic lung disease. Although engineering controls to reduce inhalation of RCS have been known and available for decades, people continue to succumb to its associated health effects. Researchers in the Engineering and Physical Hazards Branch (EPHB), in the Division of Field Studies and Engineering (DFSE) at NIOSH, have extensively studied engineering controls for tasks that produce RCS. In other NIOSH divisions, research on RCS controls also continues to be a priority. Silica, or silicon dioxide (SiO2), can be found in crystalline or amorphous forms. Its most abundant crystalline form is alpha quartz, an extremely common mineral found in sand, gravel, soil, clay, shale, slate, sandstone, granite, calcined diatomaceous earth, portland cement concrete, asphalt pavement, ceramics, brick, tile, masonry, mortar, and other materials. It is frequently found alongside deposits of ores and other resources that are mined, such as coal. We are surrounded by it-we walk on it, drive on it, eat and drink from it, and build with it. Although it can comprise many useful materials, it becomes hazardous after it is pulverized, aerosolized, and inhaled. |
Data modernization: Making environmental health services data more accessible
Rodriguez Luis , Wilson Holly . J Environ Health 2022 84 (8) 34-36 The article discusses the data modernization efforts in various U.S. states to increase the accessibility of environmental health services data. Also cited are the partnership between the Environmental Public Health Tracking Program and the Centers for Disease Control and Prevention's (CDC) Water, Food and Environmental Services Branch (WFEHSB) to advance modernization, and the focus on environmental health services like inspections, permits, and public inquiries. |
Evaluation of a laboratory-developed multiplex real-time PCR assay for diagnosis of syphilis, herpes and chancroid genital ulcers in four public health laboratories in the USA.
Koralur M , Chen CY , Pillay A , White B , Pettus K , Chi KH , Stringer J , Aroh C , Dasu T , Bhattacharyya S , Perkins K , Chen J , Riner D , Soehnlen M , Cao W , Gaynor AM , Kersh EN . Sex Transm Infect 2021 98 (6) 448-450 OBJECTIVE: To evaluate the field performance of a multiplex PCR (M-PCR) assay for detection of herpes simplex virus (HSV)-1 and HSV-2, Treponema pallidum (T. pallidum) and Haemophilus ducreyi (H. ducreyi) in genital ulcer disease (GUD) specimens. METHODS: GUD M-PCR was performed on 186 remnant specimens, previously collected for HSV testing, by four public health laboratories (PHLs) and the Laboratory Reference and Research Branch (LRRB) at the Centers for Disease Control and Prevention. The results from the PHLs were compared with those of LRRB, which served as the reference testing method, and percentage agreement was calculated. RESULTS: HSV was detected in 31 of 52 (59.6%), 20 of 40 (50%), 43 of 44 (97.7%) and 19 of 50 (38.0%) specimens from PHL1, PHL2, PHL3 and PHL4, respectively. There were seven discrepant results for HSV, and the overall percent agreement between the PHLs and the LRRB was 94%-100%, with a kappa value of 0.922, which demonstrates high agreement. T. pallidum was identified in 7 of 51 (13.7%) specimens from PHL1 with 94.1% agreement and in 2 of 40 (5.0%) specimens from PHL2 with 100% agreement. The LRRB identified three additional T. pallidum-positive specimens from PHL1. The kappa value (0.849) for T. pallidum testing suggests good agreement. Consistent with the LRRB results, no T. pallidum was detected in specimens from PHL3 and PHL4, and H. ducreyi was not detected at any of the study sites. CONCLUSIONS: The GUD M-PCR assay performed well in four independent PHLs and 12 suspected syphilis cases were identified in this study. The M-PCR assay could provide improved diagnostic options for GUD infections in state and local PHLs. |
Public health branch incident management and support as part of the Federal Government response during the emergency phase of Hurricanes Irma and Maria in Puerto Rico and the US Virgin Islands
Cruz MA , Rivera-González LO , Irvin-Barnwell E , Cabrera-Marquez J , Ellis E , Ellis B , Qi B , Maniglier-Poulet C , Gerding JA , Shumate A , Andujar A , Yoder J , Laco J , Santana A , Bayleyegn T , Luna-Pinto C , Rodriguez LO , Roth J , Bermingham J , Funk RH , Raheem M . J Emerg Manag 2021 19 (8) 63-77 On September 6 and 20, 2017, Hurricanes Irma and Maria made landfall as major hurricanes in the US Caribbean Territories of the Virgin Islands and Puerto Rico with devastating effects. As part of the initial response, a public health team (PHT) was initially deployed as part of the US Department of Health and Human Services Incident Response Coordination Team. As a result of increased demands for additional expertise and resources, a public health branch (PHB) was established for coordinating a broad spectrum of public health response activities in support of the affected territories. This paper describes the conceptual framework for organizing these activities; summarizes some key public health activities and roles; outlines partner support and coordination with key agencies; and defines best practices and areas for improvement in disaster future operations. © 2021 Weston Medical Publishing. All rights reserved. |
Inference of Nipah virus evolution, 1999-2015.
Whitmer SLM , Lo MK , Sazzad HMS , Zufan S , Gurley ES , Sultana S , Amman B , Ladner JT , Rahman MZ , Doan S , Satter SM , Flora MS , Montgomery JM , Nichol ST , Spiropoulou CF , Klena JD . Virus Evol 2021 7 (1) veaa062 Despite near-annual human outbreaks of Nipah virus (NiV) disease in Bangladesh, typically due to individual spillover events from the local bat population, only twenty whole-genome NiV sequences exist from humans and ten from bats. NiV whole-genome sequences from annual outbreaks have been challenging to generate, primarily due to the low viral load in human throat swab and serum specimens. Here, we used targeted enrichment with custom NiV-specific probes and generated thirty-five additional unique full-length genomic sequences directly from human specimens and viral isolates. We inferred the temporal and geographic evolutionary history of NiV in Bangladesh and expanded a tool to visualize NiV spatio-temporal spread from a Bayesian continuous diffusion analysis. We observed that strains from Bangladesh segregated into two distinct clades that have intermingled geographically in Bangladesh over time and space. As these clades expanded geographically and temporally, we did not observe evidence for significant branch and site-specific selection, except for a single site in the Henipavirus L polymerase. However, the Bangladesh 1 and 2 clades are differentiated by mutations initially occurring in the polymerase, with additional mutations accumulating in the N, G, F, P, and L genes on external branches. Modeling the historic geographical and temporal spread demonstrates that while widespread, NiV does not exhibit significant genetic variation in Bangladesh. Thus, future public health measures should address whether NiV within in the bat population also exhibits comparable genetic variation, if zoonotic transmission results in a genetic bottleneck and if surveillance techniques are detecting only a subset of NiV. Copyright © 2020 Published by Oxford University Press 2020. This work is written by a US Government employee and is in the public domain in the US. |
Leading Organizational Change: Improved Leadership Behaviors Among Public Health Leaders After Receiving Multirater Feedback and Coaching
Spears-Jones C , Myles R , Porch T , Parris S , Ivy-Knudsen M , Dean HD . Workplace Health Saf 2021 69 (9) 21650799211001728 BACKGROUND: Leading Change is one of five Executive Core Qualifications (ECQs) used in developing leaders in the federal government. Leadership development programs that incorporate multirater feedback and executive coaching are valuable in developing competencies to lead change. METHODS: We examined the extent by which coaching influenced Leading Change competencies and identified effective tools and resources used to enhance the leadership capacity of first- and midlevel leaders at Centers for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention. Data included qualitative data collected via semi-structured interviews that focused on leadership changes made by leaders in the Coaching and Leadership Initiative (CaLI), a leadership development program for Team Leads and Branch Chiefs. FINDINGS: Ninety-six participants completed leadership coaching; 94 (98%) of whom completed one or more interviews. Of those 94 respondents, 74 (79%) reported improvements in their ability to lead change in 3 of 4 leading change competencies: creativity and innovation, flexibility, and resilience. All respondents indicated tools and resources that were effective in leading change: 49 (52%) participated in instructor-led activities during their CaLI experience; 33 (35%) experiential activities; 94 (100%) developmental relationships, assessment, and feedback; and 25 (27%) self-development. CONCLUSIONS/APPLICATION TO PRACTICE: First- and midlevel leaders in a public health agency benefitted from using leadership coaching in developing competencies to lead organizational change. Leadership development programs might benefit from examining Leading Change competencies and including instructor-led and experiential activities as an additional component of a comprehensive leadership development program. |
Communicating effectively to overcome misinformation
Khan A , Dove T , Segerlind S . J Environ Health 2021 83 (6) 44-46 Editor's Note: The National Environmental Health Association strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we feature a column on environmental health services from the Centers for Disease Control and Prevention (CDC) in every issue of the Journal. | | In these columns, authors from CDC's Water, Food, and Environmental Health Services Branch, as well as guest authors, will share insights and information about environmental health programs, trends, issues, and resources. The conclusions of these columns are those of the author(s) and do not necessarily represent the official position of CDC. | | Water Management Programs Are Key to Managing Legionella Growth and Spread | Elaine Curtiss, MEd, National Center for Environmental Health, Centers for Disease Control and Prevention | Janie Hils, MPH, National Center for Environmental Health, Centers for Disease Control and Prevention | CDR Jasen Kunz, MPH, REHS/RS, National Center for Environmental Health, Centers for Disease Control and Prevention | In summer 2021, several U.S. public health jurisdictions reported increases in Legionnaires' disease cases above their respective 5-year baseline averages. While the Centers for Disease Control and Prevention (CDC) does not know to what extent building water systems might have contributed to these increases, periods of reduced building occupancy or building closure and low water usage can create hazards for occupants. Reopening schools, workplaces, and businesses—and more people traveling and staying in hotels—can elevate the risk of exposure to Legionella bacteria if appropriate steps are not taken. Environmental health professionals have an important role in reminding building owners, building operators, and cooling tower operators of ways to safely reopen buildings to prevent the growth of Legionella. | | Water management programs help people identify hazardous conditions and take steps to minimize the growth and spread of Legionella and other waterborne pathogens in building water systems. Developing and maintaining a water management program is a multistep process that requires continuous review. This month's column provides several different resources from CDC to aid in the development of water management programs and prevent the spread and growth of Legionella. |
Advancing environmental health practice through environmental health informatics activities
Coleman EW , Jagne AF . J Environ Health 2020 83 (4) 30-31 Environmental health programs collect data (e.g., inspection results) that might not be routinely analyzed for trends or used to inform timely public health decision-making. State, tribal, local, and territorial health departments and environmental health programs, however, can lack resources, time, or the experience to collect, analyze, and visualize EH data. Leveraging the use of informatics by standardizing data collection, sharing, and utilization can support innovative approaches to improving EH practice. | | The Centers for Disease Control and Prevention (CDC) Water, Food, and Environmental Health Services Branch supports the work of EH informatics through collaborative activities that | | promote timely public data and information sharing to detect and address existing or potential exposures to EH hazards, | support best practices for the innovative use of existing data and electronic information to design interventions to protect public health, and | identify environmental and health outcome indicators to assess the need for and impact of EH services. | This month's column explores designing an open data standard to improve health and safety in aquatic facilities, as well as leveraging informatics to improve environmental health practice and innovation. |
Assessing the Performance of Dried-Blood-Spot DNA Extraction Methods in Next Generation Sequencing.
Hendrix MM , Cuthbert CD , Cordovado SK . Int J Neonatal Screen 2020 6 (2) 1-15 An increasing number of newborn screening laboratories in the United States and abroad are moving towards incorporating next-generation sequencing technology, or NGS, into routine screening, particularly for cystic fibrosis. As more programs utilize this technology for both cystic fibrosis and beyond, it is critical to identify appropriate DNA extraction methods that can be used with dried blood spots that will result in consistent, high-quality sequencing results. To provide comprehensive quality assurance and technical assistance to newborn screening laboratories wishing to incorporate NGS assays, CDC's Newborn Screening and Molecular Biology Branch designed a study to evaluate the performance of nine commercial or laboratory-developed DNA extraction methods that range from a highly purified column extraction to a crude detergent-based no-wash boil prep. The DNA from these nine methods was used in two NGS library preparations that interrogate the CFTR gene. All DNA extraction methods including the cruder preps performed reasonably well with both library preps. One lower-concentration, older sample was excluded from one of the assay evaluations due to poor performance across all DNA extraction methods. When 84 samples, versus eight, were run on a flow cell, the DNA quality and quantity were more significant variables. |
Co-occurrence of antibiotic, biocide, and heavy metal resistance genes in bacteria from metal and radionuclide contaminated soils at the Savannah River Site.
Thomas JC4th , Oladeinde A , Kieran TJ , Finger JWJr , Bayona-Vasquez NJ , Cartee JC , Beasley JC , Seaman JC , McArthur JV , Rhodes OEJr , Glenn TC . Microb Biotechnol 2020 13 (4) 1179-1200 Contaminants such as heavy metals may contribute to the dissemination of antimicrobial resistance (AMR) by enriching resistance gene determinants via co-selection mechanisms. In the present study, a survey was performed on soils collected from four areas at the Savannah River Site (SRS), South Carolina, USA, with varying contaminant profiles: relatively pristine (Upper Three Runs), heavy metals (Ash Basins), radionuclides (Pond B) and heavy metal and radionuclides (Tim's Branch). Using 16S rRNA gene amplicon sequencing, we explored the structure and diversity of soil bacterial communities. Sites with legacies of metal and/or radionuclide contamination displayed significantly lower bacterial diversity compared to the reference site. Metagenomic analysis indicated that multidrug and vancomycin antibiotic resistance genes (ARGs) and metal resistance genes (MRGs) including those associated with copper, arsenic, iron, nickel and zinc were prominent in all soils including the reference site. However, significant differences were found in the relative abundance and diversity of certain ARGs and MRGs in soils with metal/radionuclide contaminated soils compared to the reference site. Co-occurrence patterns revealed significant ARG/MRG subtypes in predominant soil taxa including Acidobacteriaceae, Bradyrhizobium, Mycobacterium, Streptomyces, Verrumicrobium, Actinomadura and Solirubacterales. Overall, the study emphasizes the potential risk of human activities on the dissemination of AMR in the environment. |
Using the contribution analysis approach to evaluate science impact: A case study of the National Institute for Occupational Safety and Health
Downes A , Novicki E , Howard J . Am J Eval 2019 40 (2) 177-189 Interest from Congress, executive branch leadership, and various other stakeholders for greater accountability in government continues to gain momentum today with government-wide efforts. However, measuring the impact of research programs has proven particularly difficult. Cause and effect linkages between research findings and changes to morbidity and mortality are difficult to prove. To address this challenge, the National Institute for Occupational Safety and Health program evaluators used a modified version of contribution analysis (CA) to evaluate two research programs. CA proved to be a useful framework for assessing research impact, and both programs received valuable, actionable feedback. Although there is room to further refine our approach, this was a promising step toward moving beyond bibiliometrics to more robust assessment of research impact. |
Targeted deep amplicon sequencing of kelch 13 and cytochrome b in Plasmodium falciparum isolates from an endemic African country using the Malaria Resistance Surveillance (MaRS) protocol.
L'Episcopia M , Kelley J , Patel D , Schmedes S , Ravishankar S , Menegon M , Perrotti E , Nurahmed AM , Talha AA , Nour BY , Lucchi N , Severini C , Talundzic E . Parasit Vectors 2020 13 (1) 137 BACKGROUND: Routine molecular surveillance for imported drug-resistant malaria parasites to the USA and European Union is an important public health activity. The obtained molecular data are used to help keep chemoprophylaxis and treatment guidelines up to date for persons traveling to malaria endemic countries. Recent advances in next-generation sequencing (NGS) technologies provide a new and effective way of tracking malaria drug-resistant parasites. METHODS: As part of a technology transfer arrangement between the CDC Malaria Branch and the Istituto Superiore di Sanita (ISS), Rome, Italy, the recently described Malaria Resistance Surveillance (MaRS) protocol was used to genotype 148 Plasmodium falciparum isolates from Eritrea for kelch 13 (k13) and cytochrome b (cytb) genes, molecular markers associated with resistance to artemisinin (ART) and atovaquone/proguanil (AP), respectively. RESULTS: Spanning the full-length k13 gene, seven non-synonymous single nucleotide polymorphisms (SNPs) were found (K189N, K189T, E208K, D281V, E401Q, R622I and T535M), of which none have been associated with artemisinin resistance. No mutations were found in cytochrome b. CONCLUSION: All patients successfully genotyped carried parasites susceptible to ART and AP treatment. Future studies between CDC Malaria Branch and ISS are planned to expand the MaRS system, including data sharing, in an effort to maintain up to date treatment guidelines for travelers to malaria endemic countries. |
Putting guidance into practice: Interpretation of the oral cholera vaccine recommendations for U.S. travelers
Conners EE , Angelo KM , Walker AT . Am J Trop Med Hyg 2020 102 (3) 491-493 The American Committee on Immunization Practices recommends the use of the oral cholera vaccine (OCV) in international travelers aged 18-64 years who visit areas of active cholera transmission. CDC Travelers' Health Branch currently tracks areas of active cholera transmission and posts this information on their country-specific destination web pages at https://wwwnc.cdc.gov/travel/destinations/list. Lessons learned from a webinar conducted among health care providers have led to improvements in how CDC shares information on the OCV. Here, we summarize the major considerations for providers offering the OCV to U.S. travelers and indicate where they can find more information. |
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