Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Clippard JR[original query] |
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Use of influenza antiviral medications among outpatients at high risk for influenza-associated complications during the 2013-14 influenza season
Havers FP , Flannery B , Clippard JR , Gaglani M , Zimmerman RK , Jackson LA , Petrie JG , McLean HQ , Nowalk MP , Jackson ML , Monto AS , Belongia EA , Eng HF , Lamerato L , Campbell AP , Fry AM . Clin Infect Dis 2015 60 (11) 1677-80 During the 2013-14 influenza season, we analyzed data from 6,004 outpatients aged ≥6 months with acute respiratory illness (ARI). Among the 2,786 ARI patients at higher risk for influenza complications, 835 (30%) presented to care ≤2 days from symptom onset; among those, 126 (15%) were prescribed an antiviral medication. |
Influenza vaccine effectiveness in the United States during 2012-13: variable protection by age and virus type
McLean HQ , Thompson MG , Sundaram ME , Kieke BA , Gaglani M , Murthy K , Piedra PA , Zimmerman RK , Nowalk MP , Raviotta JM , Jackson ML , Jackson L , Ohmit SE , Petrie JG , Monto AS , Meece JK , Thaker SN , Clippard JR , Spencer SM , Fry AM , Belongia EA . J Infect Dis 2014 211 (10) 1529-40 BACKGROUND: During the 2012-13 influenza season, there was co-circulation of A/H3N2 and two B lineage viruses in the United States. METHODS: Patients with acute cough illness ≤7 days duration were prospectively enrolled and swabbed at outpatient clinics in five states. Influenza vaccination dates were confirmed by medical records. Vaccine effectiveness (VE) was estimated as [100% x (1-adjusted odds ratio)] for vaccination in cases vs. test-negative controls. RESULTS: Influenza was detected in 2,307 (36%) of 6,452 patients; 1,292 (56%) had A/H3N2, 582 (25%) had B/Yamagata, and 303 (13%) had B/Victoria. VE was 49% (95% CI: 43, 55) overall; 39% (95% CI: 29, 47) against A/H3N2, 66% (95% CI: 58, 73) against B/Yamagata (vaccine lineage), and 51% (95% CI: 36, 63) against B/Victoria. VE against A/H3N2 was highest among persons aged 50-64 years (52%; 95% CI: 33, 65) and 6 months-8 years (51%; 95% CI: 32, 64) and lowest among those ≥65 years (11%; 95% CI: -41, 43). In younger age groups, there was evidence of residual protection from receipt of the 2011-12 vaccine one year earlier. CONCLUSIONS: The 2012-13 vaccines were moderately effective in most age groups. Cross-lineage protection and residual effects from prior vaccination were observed and warrant further investigation. |
Animal bite and rabies postexposure prophylaxis reporting - United States, 2013
Vora NM , Clippard JR , Stobierski MG , Signs K , Blanton JD . J Public Health Manag Pract 2014 21 (3) E24-7 CONTEXT: Rabies virus causes a fatal encephalitis and is typically acquired through the bite of an infected mammal. Rabies is preventable through administration of rabies postexposure prophylaxis (PEP), but this must be balanced with the need to avoid unnecessary PEP use. Though not nationally notifiable, some state health departments (SHDs) have made animal bites and use of PEP reportable within their jurisdictions. OBJECTIVE: We evaluated whether animal bites and PEP were reportable to SHDs as of 2013 for every state in the United States. DESIGN: The list of reportable conditions for each SHD as of 2013 was reviewed on the Internet for every state in the United States to determine whether animal bites or PEP were reportable. We then contacted an SHD representative (typically the State Public Health Veterinarian) to confirm data generated through Internet searches. Health departments in states where PEP was reportable were asked to complete a follow-up survey. RESULTS: Animal bites and PEP both were reportable in 9 states (18%). Another 9 states (18%) mandated animal bite reporting but not PEP reporting, while 12 states (24%) mandated PEP reporting but not animal bite reporting. These events were not reportable in 20 states (40%). The benefits reported by personnel from SHDs with PEP reporting systems varied greatly. CONCLUSIONS: Additional investigations focusing on the value of information returned by PEP reporting and identifying best practices for implementation and management are needed. The lack of standardization between current animal bite and PEP reporting systems limits completeness of reporting and comparability of outcomes. National recommendations to standardize case definitions and other data elements might help jurisdictions developing new animal bite or PEP reporting systems. |
Use of influenza antiviral agents by ambulatory care clinicians during the 2012-2013 influenza season
Havers F , Thaker S , Clippard JR , Jackson M , McLean HQ , Gaglani M , Monto AS , Zimmerman RK , Jackson L , Petrie JG , Nowalk MP , Moehling KK , Flannery B , Thompson MG , Fry AM . Clin Infect Dis 2014 59 (6) 774-82 BACKGROUND: Early antiviral treatment (≤2 days since illness onset) of influenza reduces the probability of influenza-associated complications. Early empiric antiviral treatment is recommended for those with suspected influenza at higher risk for influenza complications regardless of their illness severity. We describe antiviral receipt among outpatients with acute respiratory illness (ARI) and antibiotic receipt among patients with influenza. METHODS: We analyzed data from 5 sites in the US Influenza Vaccine Effectiveness Network Study during the 2012-2013 influenza season. Subjects were outpatients aged ≥6 months with ARI defined by cough of ≤7 days' duration; all were tested for influenza by polymerase chain reaction (PCR). Medical history and prescription information were collected by medical and pharmacy records. Four sites collected prescribing data on 3 common antibiotics (amoxicillin-clavulanate, amoxicillin, and azithromycin). RESULTS: Of 6766 enrolled ARI patients, 509 (7.5%) received an antiviral prescription. Overall, 2366 (35%) had PCR-confirmed influenza; 355 (15%) of those received an antiviral prescription. Among 1021 ARI patients at high risk for influenza complications (eg, aged <2 years or ≥65 years or with ≥1 chronic medical condition) presenting to care ≤2 days from symptom onset, 195 (19%) were prescribed an antiviral medication. Among participants with PCR-confirmed influenza and antibiotic data, 540 of 1825 (30%) were prescribed 1 of 3 antibiotics; 297 of 1825 (16%) were prescribed antiviral medications. CONCLUSIONS: Antiviral treatment was prescribed infrequently among outpatients with influenza for whom therapy would be most beneficial; in contrast, antibiotic prescribing was more frequent. Continued efforts to educate clinicians on appropriate antibiotic and antiviral use are essential to improve healthcare quality. |
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