Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Crisp C[original query] |
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Notes from the field: Cruise ship norovirus outbreak associated with person-to-person transmission - United States Jurisdiction, January 2023
Crisp CA , Jenkins KA , Dunn I , Kupper A , Johnson J , White S , Moritz ED , Rodriguez LO . MMWR Morb Mortal Wkly Rep 2023 72 (30) 833-834 CDC’s Vessel Sanitation Program (VSP) monitors cases of acute gastroenteritis (AGE) on board cruise ships traveling to a U.S. port (1). Persons who have ≥3 loose stools (or more than normal for that person) within a 24-hour period or vomiting plus one other sign or symptom (e.g., fever, diarrhea, bloody stool, myalgia, abdominal cramps, or headache) meet the case definition for reportable AGE (2). When the percentage of passengers or crew members with AGE is ≥2% and the ship is due to arrive at a U.S. port within 15 days, the Maritime Illness Disease Reporting System alerts VSP and activates an investigation (1). During the first week of January 2023, VSP was notified of cases of AGE affecting >2% of passengers on board a ship that had completed three voyages in Europe and was within 15 days of arriving at a U.S. port (voyage 4)* (Figure). Ship medical crew members submitted stool samples from ill travelers for testing. All samples tested positive for norovirus genotype II. While the ship was sailing to a U.S. port, VSP monitored AGE cases on board and reviewed case data. By mid-January, passenger AGE prevalence reached 3.4%. |
Acute kidney injury among children likely associated with diethylene glycol-contaminated medications - The Gambia, June-September 2022
Bastani P , Jammeh A , Lamar F , Malenfant JH , Adewuyi P , Cavanaugh AM , Calloway K , Crisp C , Fofana N , Hallett TC , Jallow A , Muoneke U , Nyassi M , Thomas J , Troeschel A , Yard E , Yeh M , Bittaye M . MMWR Morb Mortal Wkly Rep 2023 72 (9) 217-222 On July 26, 2022, a pediatric nephrologist alerted The Gambia's Ministry of Health (MoH) to a cluster of cases of acute kidney injury (AKI) among young children at the country's sole teaching hospital, and on August 23, 2022, MoH requested assistance from CDC. CDC epidemiologists arrived in The Gambia, a West African country, on September 16 to assist MoH in characterizing the illness, describing the epidemiology, and identifying potential causal factors and their sources. Investigators reviewed medical records and interviewed caregivers to characterize patients' symptoms and identify exposures. The preliminary investigation suggested that various contaminated syrup-based children's medications contributed to the AKI outbreak. During the investigation, MoH recalled implicated medications from a single international manufacturer. Continued efforts to strengthen pharmaceutical quality control and event-based public health surveillance are needed to help prevent future medication-related outbreaks. |
Achieving reductions in opioid dispensing: A qualitative comparative analysis of state-level efforts to improve prescribing
Underwood NL , Kane H , Cance J , Emery K , Elek E , Zule W , Rooks-Peck C , Sargent W , Mells J . J Public Health Manag Pract 2022 29 (2) 262-270 OBJECTIVE: To determine whether any combinations of state-level public health activities were necessary or sufficient to reduce prescription opioid dispensing. DESIGN: We examined 2016-2019 annual progress reports, 2014-2019 national opioid dispensing data (IQVIA), and interview data from states to categorize activities. We used crisp-set Qualitative Comparative Analysis to determine which program activities, individually or in combination, were necessary or sufficient for a better than average decrease in morphine milligram equivalent (MME) per capita. SETTING: Twenty-nine US state health departments. PARTICIPANTS: State health departments implementing the Centers for Disease Control and Prevention's Prevention for States (PfS) program. MAIN OUTCOME: Combinations of prevention activities related to changes in the rate of prescription opioid MME per capita dispensing from 2014 to 2019. RESULTS: Three combinations were sufficient for greater than average state-level reductions in MME per capita: (1) expanding and improving proactive reporting in combination with enhancing the uptake of evidence-based opioid prescribing guidelines and not moving toward a real-time Prescription Drug Monitoring Program; (2) implementing or improving prescribing interventions for insurers, health systems, or pharmacy benefit managers in combination with enhancing the uptake of evidence-based opioid prescribing guidelines; and (3) not implementing or improving prescribing interventions for insurers, health systems, or pharmacy benefit managers in combination with not enhancing the uptake of evidence-based opioid prescribing guidelines. Interview data suggested that the 3 combinations indicate how state contexts and history with addressing opioid overdose shaped programming and the ability to reduce MME per capita. CONCLUSIONS: States successful in reducing opioid dispensing selected activities that built upon existing policies and interventions, which may indicate thoughtful use of resources. To maximize impact in addressing the opioid overdose epidemic, states and agencies may benefit from building on existing policies and interventions. |
Cohort profile: China respiratory illness surveillance among pregnant women (CRISP), 2015-2018
Chen L , Zhou S , Zhang Z , Wang Y , Bao L , Tan Y , Sheng F , Song Y , Zhang R , Danielle Iuliano A , Thompson MG , Greene CM , Zhang J . BMJ Open 2018 8 (4) e019709 PURPOSE: We established the China Respiratory Illness Surveillance among Pregnant women (CRISP) to conduct active surveillance for influenza-associated respiratory illness during pregnancy in China from 2015 to 2018. Among annual cohorts of pregnant women, we assess the incidence of acute respiratory illness (ARI), influenza-like illness (ILI), laboratory-confirmed influenza virus infection and the seroconversion proportion during the winter influenza season. We also plan to examine the effect of influenza virus infection on adverse pregnancy, delivery and infant health outcomes with cumulative data from the three annual cohorts. PARTICIPANTS: Cohort nurses enrol pregnant women in different trimesters of pregnancy from prenatal care facilities in Suzhou, Jiangsu Province, eastern China. Pregnant women who plan to deliver in the study facilities are eligible. Pregnant women who are seeking care for anything other than routine prenatal care, such as confirmation of low progesterone and threatened miscarriage, are excluded. At enrolment, study nurses collect baseline information on demographics, education-level attained, underlying medical conditions, seasonal influenza vaccination receipt, risk factors for influenza infection, gravidity and parity and contact information. For each participant, cohort nurses conduct twice weekly follow-up contacts, one phone call and one WeChat message (free instant messaging), from the time of enrolment until delivery or termination of pregnancy. During follow-up, study nurses ask about symptoms, timing and characteristics of ARI, healthcare-seeking behaviour and medications taken for participants reporting respiratory illness since the last contact. In addition, we collect combined nasal and throat swabs for identified ARI to test for influenza viruses. We collect paired sera before and after the influenza season. Active respiratory illness surveillance and seroinfection data during pregnancy of participants are linked to their medical record and the Suzhou Maternal Child Information System for detailed information on clinical treatment for respiratory illness, pregnancy, delivery and infant health outcomes. FINDINGS TO DATE: In 2015-2016, of 4915 pregnant women approached, 192 (4%) refused to participate, 91 (2%) were ineligible because they did not plan to deliver in one of the study hospitals or because their visit was for anything other than routine prenatal care and 4632 (94%) were enrolled, 46% during their first trimester of pregnancy (range 5-12 weeks), 48% during the second trimester (range 13-27 weeks) and 6% during the third trimester (range 28-37 weeks). The median age of the enrollees was 27 years (range 16-45) and two (0.04%, 95% CI 0.01% to 0.17%) reported influenza vaccination in the previous 12 months before pregnancy, while zero reported influenza vaccination in the previous 12 months during pregnancy. During the observation time of 648 518 person-days, 1355 ARI episodes were identified. Among 1127 swabs collected (for 83% of all ARIs), 68 (6%) tested positive for influenza virus, for a laboratory-confirmed influenza incidence of 0.31 (95% CI 0.25 to 0.40) per 100 person-months during pregnancy in the study cohort. FUTURE PLANS: Results will be used to describe influenza disease burden in this population to model potential numbers of influenza illnesses averted if influenza vaccination coverage were increased and to support enhanced influenza prevention and control strategies among pregnant women in China. We also plan to enrol and follow three cohorts of pregnant women over three influenza seasons during 2015-2018 which will allow an analysis of the effect of influenza virus infection during pregnancy on adverse pregnancy, delivery and infant outcomes. |
Pathways to program success: A qualitative comparative analysis (QCA) of communities putting prevention to work case study programs
Kane H , Hinnant L , Day K , Council M , Tzeng J , Soler R , Chambard M , Roussel A , Heirendt W . J Public Health Manag Pract 2016 23 (2) 104-111 OBJECTIVE: To examine the elements of capacity, a measure of organizational resources supporting program implementation that result in successful completion of public health program objectives in a public health initiative serving 50 communities. DESIGN: We used crisp set Qualitative Comparative Analysis (QCA) to analyze case study and quantitative data collected during the evaluation of the Communities Putting Prevention to Work (CPPW) program. SETTING: CPPW awardee program staff and partners implemented evidence-based public health improvements in counties, cities, and organizations (eg, worksites, schools). PARTICIPANTS: Data came from case studies of 22 CPPW awardee programs that implemented evidence-based, community- and organizational-level public health improvements. INTERVENTION: Program staff implemented a range of evidence-based public health improvements related to tobacco control and obesity prevention. MAIN OUTCOME MEASURE: The outcome measure was completion of approximately 60% of work plan objectives. RESULTS: Analysis of the capacity conditions revealed 2 combinations for completing most work plan objectives: (1) having experience implementing public health improvements in combination with having a history of collaboration with partners; and (2) not having experience implementing public health improvements in combination with having leadership support. CONCLUSION: Awardees have varying levels of capacity. The combinations identified in this analysis provide important insights into how awardees with different combinations of elements of capacity achieved most of their work plan objectives. Even when awardees lack some elements of capacity, they can build it through strategies such as hiring staff and engaging new partners with expertise. In some instances, lacking 1 or more elements of capacity did not prevent an awardee from successfully completing objectives. IMPLICATIONS FOR POLICY & PRACTICE: These findings can help funders and practitioners recognize and assemble different aspects of capacity to achieve more successful programs; awardees can draw on extant organizational strengths to compensate when other aspects of capacity are absent. |
Public health then and now: celebrating 50 years of MMWR at CDC. Foreword
Frieden TR . MMWR Suppl 2011 60 (4) 1 Alexander Langmuir became the first Chief Epidemiologist at CDC (then called the Communicable Disease Center) in 1949. One of his many enduring contributions to the agency and to public health was to engineer the transfer in 1961 of the Morbidity and Mortality Weekly Report (MMWR) from its former home at the National Office of Vital Statistics to CDC. This supplement to MMWR celebrates the anniversary of its arrival at CDC and the 50‐year contribution it has made to CDC and public health. Langmuir had the foresight to envision the revitalization of the decades‐old publication, not only to enable CDC to share its work with the nation, but also to influence the practice and impact of public health throughout the world. This supplement celebrates MMWR through perspectives on how public health has changed during the past 50 years. Articles in this issue reflect on how the focus of public health has expanded from communicable disease to also include a broad array of acute and chronic public health challenges. | | Langmuir had a powerful ability to visualize the future but an even more powerful ability to realize his vision through the force of his strong will and his flair for recruiting and mentoring young men and women in public health. MMWR was part of his vision, and as its unofficial editor for many years, he demanded high‐quality science presented in clear and crisp prose---qualities that have endured to the present day. | | Like so many of Langmuir's innovations, MMWR has evolved with the years but it has always remained vital to each new challenge. As CDC's flagship publication, MMWR documents the impact of public health programs throughout the United States and the world, and in many cases acts as a catalyst for improvement. When health departments or ministries seek CDC's scientific information, often driven by urgent threats to the public's health, they seek out MMWR for its clearly crafted scientific articles and reliable clinical and public health recommendations based on the best available science. | | In Langmuir's day, issuing a weekly scientific publication was unusual, if not unprecedented, at a federal agency. Langmuir could not have envisioned that his MMWR would one day be available 24 hours a day, 7 days a week on computers, cell phones, and portable electronic devices of all kinds. Today MMWR is distributed worldwide through both print and electronic media and employs the latest communications technologies, including the Internet, e‐mail, social media, and podcasts. As new methods of communication evolve, so will MMWR. | | Surveillance and epidemiology have always been the cornerstones of public health. The MMWR series has provided a mechanism to communicate data from national and international surveillance systems, as well as from epidemiologic, statistical, and laboratory research. During the past 2 decades, terrorism and emergency response, modernization and globalization of the food supply, and a wide range of environmental health threats have dramatically affected public health practice---and these stories have all been carefully told in the pages of MMWR. | | Many of the most important communicable disease events during the past 50 years have been marked by articles in MMWR. Examples include the discovery of the bacterial cause of Legionnaires disease in 1977; the initial reports linking Reye syndrome to salicylates in 1980; the first five published cases of AIDS in 1981; the first report of iatrogenic HIV transmission in 1990; the first case reports of the intentional release of anthrax spores in 2001; the first reports of severe acute respiratory syndrome (SARS) in 2003; and the first two reports of 2009 pandemic influenza A (H1N1) . | | Even in its early days at CDC, MMWR published many reports on noninfectious diseases, such as pentachlorophenol poisoning in newborn infants in 1967; lead absorption in 1973; angiosarcoma of the liver among workers exposed to polyvinyl chloride in 1974; and acute childhood leukemia in 1976. In recent years, MMWR has published more reports on noninfectious diseases, injuries, chronic diseases, and related behaviors (e.g., arthritis, autism spectrum disorder, depression, infant maltreatment, sleep deprivation, and excessive television viewing), and many reports on the leading causes of death: cardiovascular disease, smoking, stroke, obesity, and harmful alcohol use. | | In recent decades, behavioral and social science, economics, informatics, and genomics increasingly have contributed to public health, and reports of these have appeared with increasing regularity in MMWR. Public health events such as contamination of commercial food products, threats to patient safety in health‐care settings, and natural disasters (e.g., the recent floods in the Midwest, heat waves in the Northeast, the earthquake in Haiti, and flooding in Pakistan) will continue to challenge the health infrastructure. In addition, health reform and the coalescence of clinical medicine, veterinary medicine, and public health are creating new opportunities for promoting prevention as the defining concept in improving the health of the public. Innovations such as electronic health records are providing unique opportunities to better understand and improve health care and health status. Through all these changes, MMWR will continue reporting on urgent, emerging, and routine public health findings, thereby helping CDC monitor and protect the public's health at home and around the world, and will remain an essential tool for CDC's far‐ranging mission. | |
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