Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Chung Jessie R [original query] |
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Clinical Symptoms Among Ambulatory Patients Tested for SARS-CoV-2.
Chung JR , Kim SS , Jackson ML , Jackson LA , Belongia EA , King JP , Zimmerman RK , Nowalk MP , Martin ET , Monto AS , Gaglani M , Smith ME , Patel M , Flannery B . Open Forum Infect Dis 2021 8 (1) ofaa576 We compared symptoms and characteristics of 4961 ambulatory patients with and without laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection. Findings indicate that clinical symptoms alone would be insufficient to distinguish between coronavirus disease 2019 and other respiratory infections (eg, influenza) and/or to evaluate the effects of preventive interventions (eg, vaccinations). |
Effect of antigenic drift on influenza vaccine effectiveness in the United States - 2019-2020.
Tenforde MW , Kondor RJG , Chung JR , Zimmerman RK , Nowalk MP , Jackson ML , Jackson LA , Monto AS , Martin ET , Belongia EA , McLean HQ , Gaglani M , Rao A , Kim SS , Stark TJ , Barnes JR , Wentworth D , Patel MM , Flannery B . Clin Infect Dis 2020 73 (11) e4244-e4250 BACKGROUND: At the start of the 2019-2020 influenza season, concern arose that circulating B/Victoria viruses of the globally emerging clade V1A.3 were antigenically drifted from the strain included in the vaccine. Intense B/Victoria activity was followed by circulation of genetically diverse A(H1N1)pdm09 viruses, that were also antigenically drifted. We measured vaccine effectiveness (VE) in the United States against illness from these emerging viruses. METHODS: We enrolled outpatients aged ≥6 months with acute respiratory illness at five sites. Respiratory specimens were tested for influenza by reverse-transcriptase polymerase chain reaction (RT-PCR). Using the test-negative design, we determined influenza VE by virus sub-type/lineage and genetic subclades by comparing odds of vaccination in influenza cases versus test-negative controls. RESULTS: Among 8,845 enrollees, 2,722 (31%) tested positive for influenza, including 1,209 (44%) for B/Victoria and 1,405 (51%) for A(H1N1)pdm09. Effectiveness against any influenza illness was 39% (95% confidence interval [CI]: 32-44), 45% (95%CI: 37-52) against B/Victoria and 30% (95%CI: 21-39) against A(H1N1)pdm09 associated illness. Vaccination offered no protection against A(H1N1)pdm09 viruses with antigenically drifted clade 6B.1A 183P-5A+156K HA genes (VE 7%; 95%CI: -14 to 23%) which predominated after January. CONCLUSIONS: Vaccination provided protection against influenza illness, mainly due to infections from B/Victoria viruses. Vaccine protection against illness from A(H1N1)pdm09 was lower than historically observed effectiveness of 40-60%, due to late-season vaccine mismatch following emergence of antigenically drifted viruses. The effect of drift on vaccine protection is not easy to predict and, even in drifted years, significant protection can be observed. |
Evidence for Limited Early Spread of COVID-19 Within the United States, January-February 2020.
CDC COVID-19 Response Team , Jorden MA , Rudman SL , Villarino E , Hoferka S , Patel MT , Bemis K , Simmons CR , Jespersen M , Iberg Johnson J , Mytty E , Arends KD , Henderson JJ , Mathes RW , Weng CX , Duchin J , Lenahan J , Close N , Bedford T , Boeckh M , Chu HY , Englund JA , Famulare M , Nickerson DA , Rieder MJ , Shendure J , Starita LM , Armstrong Gregory L , Butler Jay C , Coletta Michael A , Kite-Powell Aaron , Bhatnagar Julu , Reagan-Steiner Sarah , Tong Suxiang , Flannery Brendan , Ferdinands Jill M , Chung Jessie R . MMWR Morb Mortal Wkly Rep 2020 69 (22) 680-684 From January 21 through February 23, 2020, public health agencies detected 14 U.S. cases of coronavirus disease 2019 (COVID-19), all related to travel from China (1,2). The first nontravel-related U.S. case was confirmed on February 26 in a California resident who had become ill on February 13 (3). Two days later, on February 28, a second nontravel-related case was confirmed in the state of Washington (4,5). Examination of four lines of evidence provides insight into the timing of introduction and early transmission of SARS-CoV-2, the virus that causes COVID-19, into the United States before the detection of these two cases. First, syndromic surveillance based on emergency department records from counties affected early by the pandemic did not show an increase in visits for COVID-19-like illness before February 28. Second, retrospective SARS-CoV-2 testing of approximately 11,000 respiratory specimens from several U.S. locations beginning January 1 identified no positive results before February 20. Third, analysis of viral RNA sequences from early cases suggested that a single lineage of virus imported directly or indirectly from China began circulating in the United States between January 18 and February 9, followed by several SARS-CoV-2 importations from Europe. Finally, the occurrence of three cases, one in a California resident who died on February 6, a second in another resident of the same county who died February 17, and a third in an unidentified passenger or crew member aboard a Pacific cruise ship that left San Francisco on February 11, confirms cryptic circulation of the virus by early February. These data indicate that sustained, community transmission had begun before detection of the first two nontravel-related U.S. cases, likely resulting from the importation of a single lineage of virus from China in late January or early February, followed by several importations from Europe. The widespread emergence of COVID-19 throughout the United States after February highlights the importance of robust public health systems to respond rapidly to emerging infectious threats. |
Effects of Influenza Vaccination in the United States during the 2018-2019 Influenza Season.
Chung JR , Rolfes MA , Flannery B , Prasad P , O'Halloran A , Garg S , Fry AM , Singleton JA , Patel M , Reed C . Clin Infect Dis 2020 71 (8) e368-e376 BACKGROUND: Current multivalent influenza vaccine products provide protection against influenza A(H1N1)pdm09, A(H3N2), and B lineage viruses. The 2018-2019 influenza season in the US included prolonged circulation of both A(H1N1)pdm09 viruses well-matched to the vaccine strain, and A(H3N2) viruses the majority of which were mismatched to the vaccine. We estimate the number of vaccine-prevented influenza-associated illnesses, medical visits, hospitalizations, and deaths for the season. METHODS: We used a mathematical model and Monte Carlo algorithm to estimate numbers and 95% uncertainty intervals (UI) of influenza-associated outcomes prevented by vaccination in the US. The model incorporated age-specific estimates of national 2018-2019 influenza vaccine coverage, influenza virus-specific vaccine effectiveness from the US Influenza Vaccine Effectiveness Network, and disease burden estimated from population-based rates of influenza-associated hospitalizations through the Influenza Hospitalization Surveillance Network. RESULTS: Influenza vaccination prevented an estimated 4.4 million (95% UI: 3.4 million-7.1 million) illnesses, 2.3 million (95% UI: 1.8 million-3.8 million) medical visits, 58,000 (95% UI: 30,000-156,000) hospitalizations, and 3,500 (95% UI: 1,000-13,000) deaths due to influenza viruses during the US 2018-2019 influenza season. Vaccination prevented 14% of projected hospitalizations associated with A(H1N1)pdm09 overall and 43% among young children aged 6 months-4 years. CONCLUSIONS: Influenza vaccination averted substantial influenza-associated disease including hospitalizations and deaths in the US, primarily due to effectiveness against A(H1N1)pdm09. Our findings underscore the value of influenza vaccination, highlighting that vaccines measurably decrease illness and associated health care utilization even in a season in which a vaccine component does not match to a circulating virus. |
Enhanced genetic characterization of influenza A(H3N2) viruses and vaccine effectiveness by genetic group, 2014-2015.
Flannery B , Zimmerman RK , Gubareva LV , Garten RJ , Chung JR , Nowalk MP , Jackson ML , Jackson LA , Monto AS , Ohmit SE , Belongia EA , McLean HQ , Gaglani M , Piedra PA , Mishin VP , Chesnokov AP , Spencer S , Thaker SN , Barnes JR , Foust A , Sessions W , Xu X , Katz J , Fry AM . J Infect Dis 2016 214 (7) 1010-9 BACKGROUND: During the 2014-15 US influenza season, expanded genetic characterization of circulating influenza A(H3N2) viruses was used to assess the impact of genetic variability of influenza A(H3N2) viruses on influenza vaccine effectiveness (VE). METHODS: A novel pyrosequencing assay was used to determine genetic group based on hemagglutinin (HA) gene sequences of influenza A(H3N2) viruses from patients enrolled US Flu Vaccine Effectiveness network sites. Vaccine effectiveness was estimated using a test-negative design comparing vaccination among patients infected with influenza A(H3N2) viruses and uninfected patients. RESULTS: Among 9710 enrollees, 1868 (19%) tested positive for influenza A(H3N2); genetic characterization of 1397 viruses showed 1134 (81%) belonged to one HA genetic group (3C.2a) of antigenically drifted H3N2 viruses. Effectiveness of 2014-15 influenza vaccination varied by A(H3N2) genetic group from 1% (95% confidence interval [CI], -14% to 14%) against illness caused by antigenically drifted A(H3N2) group 3C.2a viruses versus 44% (95% CI, 16% to 63%) against illness caused by vaccine-like A(H3N2) group 3C.3b viruses. CONCLUSION: Effectiveness of 2014-15 influenza vaccination varied by genetic group of influenza A(H3N2) virus. Changes in hemagglutinin genes related to antigenic drift were associated with reduced vaccine effectiveness. |
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