Last data update: Apr 22, 2024. (Total: 46599 publications since 2009)
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Query Trace: Dhara R[original query] |
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Influenza activity - United States, 2014-15 season and composition of the 2015-16 influenza vaccine
Appiah GD , Blanton L , D'Mello T , Kniss K , Smith S , Mustaquim D , Steffens C , Dhara R , Cohen J , Chaves SS , Bresee J , Wallis T , Xu X , Abd Elal AI , Gubareva L , Wentworth DE , Katz J , Jernigan D , Brammer L . MMWR Morb Mortal Wkly Rep 2015 64 (21) 583-590 During the 2014-15 influenza season in the United States, influenza activity increased through late November and December before peaking in late December. Influenza A (H3N2) viruses predominated, and the prevalence of influenza B viruses increased late in the season. This influenza season, similar to previous influenza A (H3N2)-predominant seasons, was moderately severe with overall high levels of outpatient illness and influenza-associated hospitalization, especially for adults aged ≥65 years. The majority of circulating influenza A (H3N2) viruses were different from the influenza A (H3N2) component of the 2014-15 Northern Hemisphere seasonal vaccines, and the predominance of these drifted viruses resulted in reduced vaccine effectiveness. This report summarizes influenza activity in the United States during the 2014-15 influenza season (September 28, 2014-May 23, 2015) and reports the recommendations for the components of the 2015-16 Northern Hemisphere influenza vaccine. |
Update: influenza activity - United States, September 28, 2014-February 21, 2015
D'Mello T , Brammer L , Blanton L , Kniss K , Smith S , Mustaquim D , Steffens C , Dhara R , Cohen J , Chaves SS , Finelli L , Bresee J , Wallis T , Xu X , Abd Elal AI , Gubareva L , Wentworth D , Villanueva J , Katz J , Jernigan D . MMWR Morb Mortal Wkly Rep 2015 64 (8) 206-12 Influenza activity in the United States began to increase in mid-November, remained elevated through February 21, 2015, and is expected to continue for several more weeks. To date, influenza A (H3N2) viruses have predominated overall. As has been observed in previous seasons during which influenza A (H3N2) viruses predominated, adults aged ≥65 years have been most severely affected. The cumulative laboratory-confirmed influenza-associated hospitalization rate among adults aged ≥65 years is the highest recorded since this type of surveillance began in 2005. This age group also accounts for the majority of deaths attributed to pneumonia and influenza. The majority of circulating influenza A (H3N2) viruses are different from the influenza A (H3N2) component of the 2014-15 Northern Hemisphere seasonal vaccines, and the predominance of these antigenically and genetically drifted viruses has resulted in reduced vaccine effectiveness. This report summarizes U.S. influenza activity* since September 28, 2014, and updates the previous summary. |
Influenza activity - United States, 2013-14 season and composition of the 2014-15 influenza vaccines
Epperson S , Blanton L , Kniss K , Mustaquim D , Steffens C , Wallis T , Dhara R , Leon M , Perez A , Chaves SS , Elal AA , Gubareva L , Xu X , Villanueva J , Bresee J , Cox N , Finelli L , Brammer L . MMWR Morb Mortal Wkly Rep 2014 63 (22) 483-90 During the 2013-14 influenza season in the United States, influenza activity increased through November and December before peaking in late December. Influenza A (H1N1)pdm09 (pH1N1) viruses predominated overall, but influenza B viruses and, to a lesser extent, influenza A (H3N2) viruses also were reported in the United States. This influenza season was the first since the 2009 pH1N1 pandemic in which pH1N1 viruses predominated and was characterized overall by lower levels of outpatient illness and mortality than influenza A (H3N2)-predominant seasons, but higher rates of hospitalization among adults aged 50-64 years compared with recent years. This report summarizes influenza activity in the United States for the 2013-14 influenza season (September 29, 2013-May 17, 2014dagger) and reports recommendations for the components of the 2014-15 Northern Hemisphere influenza vaccines. |
Health risks, travel preparation, and illness among public health professionals during international travel
Balaban V , Warnock E , Ramana Dhara V , Jean-Louis LA , Sotir MJ , Kozarsky P . Travel Med Infect Dis 2014 12 (4) 349-54 BACKGROUND: Few data currently exist on health risks faced by public health professionals (PHP) during international travel. We conducted pre- and post-travel health surveys to assess knowledge, attitudes, and practices (KAP), and illnesses among PHP international travelers. METHOD: Anonymous surveys were completed by PHP from a large American public health agency who sought a pre-travel medical consult from September 1, 2009, to September 30, 2010. RESULTS: Surveys were completed by 122 participants; travelers went to 163 countries. Of the 122 respondents, 97 (80%) reported at least one planned health risk activity (visiting rural areas, handling animals, contact with blood or body fluids, visiting malarious areas), and 50 (41%) reported exposure to unanticipated health risks. Of the 62 travelers who visited malarious areas, 14 (23%) reported inconsistent or no use of malaria prophylaxis. Illness during travel was reported by 33 (27%) respondents. CONCLUSIONS: Most of the PHP travelers in our study reported at least one planned health risk activity, and almost half reported exposure to unanticipated health risks, and one-quarter of travelers to malarious areas reported inconsistent or no use of malaria chemoprophylaxis. Our findings highlight that communication and education outreach for PHP to prevent travel-associated illnesses can be improved. |
Update: influenza activity - United States, September 29, 2013-February 8, 2014
Arriola CS , Brammer L , Epperson S , Blanton L , Kniss K , Mustaquim D , Steffens C , Dhara R , Leon M , Perez A , Chaves SS , Katz J , Wallis T , Villanueva J , Xu X , Abd Elal AI , Gubareva L , Cox N , Finelli L , Bresee J , Jhung M . MMWR Morb Mortal Wkly Rep 2014 63 (7) 148-54 Influenza activity in the United States began to increase in mid-November and remained elevated through February 8, 2014. During that time, influenza A (H1N1)pdm09 (pH1N1) viruses predominated overall, while few B and A (H3N2) viruses were detected. This report summarizes U.S. influenza activity* during September 29, 2013-February 8, 2014, and updates the previous summary. |
Climate change & infectious diseases in India: implications for health care providers
Dhara VR , Schramm PJ , Luber G . Indian J Med Res 2013 138 (6) 847-52 Climate change has the potential to influence the earth's biological systems, however, its effects on human health are not well defined. Developing nations with limited resources are expected to face a host of health effects due to climate change, including vector-borne and water-borne diseases such as malaria, cholera, and dengue. This article reviews common and prevalent infectious diseases in India, their links to climate change, and how health care providers might discuss preventive health care strategies with their patients. |
Surveillance for influenza during the 2009 influenza A (H1N1) pandemic-United States, April 2009-March 2010
Brammer L , Blanton L , Epperson S , Mustaquim D , Bishop A , Kniss K , Dhara R , Nowell M , Kamimoto L , Finelli L . Clin Infect Dis 2011 52 S27-S35 The emergence in April 2009 and subsequent spread of the 2009 pandemic influenza A (H1N1) virus resulted in the first pandemic of the 21st century. This historic event was associated with unusual patterns of influenza activity in terms of the timing and persons affected in the United States throughout the summer and fall months of 2009 and the winter of 2010. The US Influenza Surveillance System identified 2 distinct waves of pandemic influenza H1N1 activity - the first peaking in June 2009, followed by a second peak in October 2009. All influenza surveillance components showed levels of influenza activity above that typically seen during late summer and early fall. During this period, influenza activity reached its highest level during the week ending 24 October 2009. This report summarizes US influenza surveillance data from 12 April 2009 through 27 March 2010. |
Epidemiology of 2009 pandemic influenza A (H1N1) deaths in the United States, April-July 2009
Fowlkes AL , Arguin P , Biggerstaff MS , Gindler J , Blau D , Jain S , Dhara R , McLaughlin J , Turnipseed E , Meyer JJ , Louie JK , Siniscalchi A , Hamilton JJ , Reeves A , Park SY , Richter D , Ritchey MD , Cocoros NM , Blythe D , Peters S , Lynfield R , Peterson L , Anderson J , Moore Z , Williams R , McHugh L . Clin Infect Dis 2011 52 S60-S68 During the spring of 2009, pandemic influenza A (H1N1) virus (pH1N1) was recognized and rapidly spread worldwide. To describe the geographic distribution and patient characteristics of pH1N1-associated deaths in the United States, the Centers for Disease Control and Prevention requested information from health departments on all laboratory-confirmed pH1N1 deaths reported from 17 April through 23 July 2009. Data were collected using medical charts, medical examiner reports, and death certificates. A total of 377 pH1N1-associated deaths were identified, for a mortality rate of .12 deaths per 100 000 population. Activity was geographically localized, with the highest mortality rates in Hawaii, New York, and Utah. Seventy-six percent of deaths occurred in persons aged 18-65 years, and 9% occurred in persons aged ≥65 years. Underlying medical conditions were reported for 78% of deaths: chronic lung disease among adults (39%) and neurologic disease among children (54%). Overall mortality associated with pH1N1 was low; however, the majority of deaths occurred in persons aged 65 years with underlying medical conditions. |
2009 pandemic influenza A (H1N1) deaths among children - United States, 2009-2010
Cox CM , Blanton L , Dhara R , Brammer L , Finelli L . Clin Infect Dis 2011 52 S69-S74 The 2009 pandemic influenza A (H1N1) (pH1N1) virus emerged in the United States in April 2009 (1) and has since caused significant morbidity and mortality worldwide (2-6). We compared pandemic influenza A (H1N1) (pH1N1)-associated deaths occurring from 15 April 2009 through 23 January 2010 with seasonal influenza-associated deaths occurring from 1 October 2007 through 14 April 2009, a period during which data collected were most comparable. Among 317 children who died of pH1N1-associated illness, 301 (95%) had a reported medical history. Of those 301, 205 (68%) had a medical condition associated with an increased risk of severe illness from influenza. Children who died of pH1N1-associated illness had a higher median age (9.4 vs 6.2 years; P.01) and longer time from onset of symptoms to death (7 vs 5 days, P.01) compared with children who died of seasonal influenza-associated illness. The majority of pediatric deaths from pH1N1 were in older children with high-risk medical conditions. Vaccination continues to be critical for all children, especially those at increased risk of influenza-related complications. |
Influenza-associated mortality among children - United States: 2007-2008
Peebles PJ , Dhara R , Brammer L , Fry AM , Finelli L . Influenza Other Respir Viruses 2011 5 (1) 25-31 BACKGROUND: Since October 2004, pediatric influenza-associated deaths have been a nationally notifiable condition. To further investigate the bacterial organisms that may have contributed to death, we systematically collected information about bacterial cultures collected at non-sterile sites and about the timing of Staphylococcus aureus specimen collection relative to hospital admission. METHODS: We performed a retrospective, descriptive study of all reported influenza-associated pediatric deaths in 2007-2008 influenza season in the United States. RESULTS: During the 2007-2008 influenza season, 88 influenza-associated pediatric deaths were reported. The median age was 5 (range 29 days - 17 years); 48% were <5 years of age. The median time from symptom onset to death was 4 days (range 0-64 days). S. aureus was identified at a sterile site or at a non-sterile site in 20 (35%) of the 57 children with specimens collected from these sites; in 17 (85%) of these children, specimens yielding S. aureus were obtained within three days of inpatient admission. These 17 children were older (10 versus 4 years, median; P < 0.05) and less likely to have a high-risk medical condition (P < 0.05) than children with cultures from the designated sites that did not grow S. aureus. CONCLUSIONS: S. aureus continues to be the most common bacteria isolated from children with influenza-associated mortality. S. aureus isolates were associated with older age and lack of high-risk medical conditions. Healthcare providers should consider influenza co-infections with S. aureus when empirically treating children with influenza and severe respiratory illness. |
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