Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-14 (of 14 Records) |
Query Trace: Farnon E[original query] |
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Multidrug-Resistant Aspergillus fumigatus Carrying Mutations Linked to Environmental Fungicide Exposure - Three States, 2010-2017.
Beer KD , Farnon EC , Jain S , Jamerson C , Lineberger S , Miller J , Berkow EL , Lockhart SR , Chiller T , Jackson BR . MMWR Morb Mortal Wkly Rep 2018 67 (38) 1064-1067 The environmental mold Aspergillus fumigatus is the primary cause of invasive aspergillosis. In patients with high-risk conditions, including stem cell and organ transplant recipients, mortality exceeds 50%. Triazole antifungals have greatly improved survival (1); however, triazole-resistant A. fumigatus infections are increasingly reported worldwide and are associated with increased treatment failure and mortality (2). Of particular concern are resistant A. fumigatus isolates carrying either TR34/L98H or TR46/Y121F/T289A genetic resistance markers, which have been associated with environmental triazole fungicide use rather than previous patient exposure to antifungals (3,4). Reports of these triazole-resistant A. fumigatus strains have become common in Europe (2,3), but U.S. reports are limited (5). Because of the risk posed to immunocompromised patients, understanding the prevalence of such isolates in patients is important to guide clinical and public health decision-making. In 2011, CDC initiated passive laboratory monitoring for U.S. triazole-resistant A. fumigatus isolates through outreach to clinical laboratories. This system identified five TR34/L98H isolates collected from 2016 to 2017 (6), in addition to two other U.S. isolates collected in 2010 and 2014 and reported in 2015 (5). Four of these seven isolates were reported from Pennsylvania, two from Virginia, and one from California. Three isolates were collected from patients with invasive pulmonary aspergillosis, and four patients had no known previous triazole exposure. A. fumigatus resistant to all triazole medications is emerging in the United States, and clinicians and public health personnel need to be aware that resistant infections are possible even in patients not previously exposed to these medications. |
Transmission of Balamuthia mandrillaris by organ transplantation
Farnon EC , Kokko K , Budge PJ , Mbaeyi C , Lutterloh E , Qvarnstrom Y , da Silva AJ , Shieh WJ , Roy S , Paddock CD , Sriram R , Zaki SR , Visvesvara G , Kuehnert MJ . Clin Infect Dis 2016 63 (7) 878-888 BACKGROUND: During 2009 and 2010, two clusters of organ transplant-transmitted Balamuthia mandrillaris, a free-living ameba, were detected by recognition of severe unexpected illness in multiple recipients from the same donor. METHODS: We investigated all recipients and the two donors through interview, medical record review, and testing of available specimens retrospectively. Surviving recipients were tested and treated prospectively. RESULTS: In the 2009 cluster of illness, two kidney recipients were infected and one died. The donor had Balamuthia encephalitis confirmed on autopsy. In the 2010 cluster, the liver and kidney-pancreas recipients developed Balamuthia encephalitis and died. The donor had a clinical syndrome consistent with Balamuthia infection and serologic evidence of infection. In both clusters, the two asymptomatic recipients were treated expectantly and survived; one asymptomatic recipient in each cluster had serologic evidence of exposure that decreased over time. Both donors had been presumptively diagnosed with other neurologic diseases prior to organ procurement. CONCLUSIONS: Balamuthia can be transmitted through organ transplantation with an observed incubation time of 17-24 days. Clinicians should be aware of Balamuthia as a cause of encephalitis with high rate of fatality, and should notify public health and evaluate transplant recipients from donors with signs of possible encephalitis to facilitate early diagnosis and targeted treatment. Organ procurement organizations and transplant centers should be aware of the potential for Balamuthia infection in donors with possible encephalitis and also assess donors carefully for signs of neurologic infection that may have been misdiagnosed as stroke or as non-infectious forms of encephalitis. |
Surveillance for respiratory infections in low- and middle-income countries: experience from the Centers for Disease Control and Prevention's Global Disease Detection International Emerging Infections Program
Breiman RF , Van Beneden CA , Farnon EC . J Infect Dis 2013 208 Suppl 3 S167-72 In 2001 with its first International Emerging Infections Program (IEIP) established in Bangkok, Thailand, the Centers for Disease Control and Prevention (CDC) began building capacity in strategically located countries for infectious disease surveillance, diagnostics, epidemic detection and response, and collection of epidemiologic data to drive policy on prevention and control of priority infectious diseases. The vision of establishing programs that focus on emerging infectious disease detection and response evolved into what are now called Global Disease Detection (GDD) Regional Centers. The GDD program was established in 2004 to provide support for the CDC's international programs and was expanded to include the IEIP and other programs as part of the GDD Regional Centers when CDC's Center for Global Health was established in 2010 [1]. The GDD Program builds global capacity to identify and respond to emerging diseases, and to conduct applied public health research on disease prevention and control [2]. The GDD Centers include 6 programs that support their host countries in building capacity to comply with the Revised International Health Regulations (IHR 2005). The 3 core programs are the International Emerging Infections Program, the cornerstone of the GDD Centers that serves as a platform to study emerging diseases and their prevention and control; the Field Epidemiology Training Program, which trains scientists in applied epidemiology and public health laboratory science; and the Influenza Program, which supports detection and response for seasonal and pandemic influenza. The remaining 3 GDD programs include the One Health Program, integrating animal and human health investigations of zoonotic diseases; the Strengthening Laboratory Capacity Program; and the Risk Communication and Emergency Response Program, supporting health communication and helping countries establish infrastructure for Emergency Operations Centers and systems. Some GDD Centers additionally have a Refugee Health Program that works closely with IEIP and other GDD programs. |
Role of global disease detection laboratories in investigations of acute respiratory illness
Fields BS , House BL , Klena J , Waboci LW , Whistler T , Farnon EC . J Infect Dis 2013 208 Suppl 3 S173-6 Since 2001, the Centers for Disease Control and Prevention (CDC) has established 10 GDD Regional Centers, serving primarily resource-constrained locations in Thailand, Kenya, Guatemala, Egypt, China, Bangladesh, Kazakhstan, India, South Africa, and Georgia [1]. GDD laboratories support the following GDD Center programs that require diagnostic testing for emerging infectious diseases: the International Emerging Infections Program (IEIP), the One Health Program, the Field Epidemiology Training Program, the Influenza Program, and the Refugee Health Program (unique to the GDD Regional Center in Kenya). The laboratory leaders at each GDD Center also serve as the center's advisor for the Strengthening Laboratory Capacity Program, through which they advise the host country on means of improving laboratory capacity to support the International Health Regulations [2]. In the 6 GDD Centers whose IEIP programs conduct population-based surveillance for acute respiratory illness and other syndromes, laboratory support is provided through GDD laboratories (in Thailand, Kenya, and Guatemala), through laboratories run by the GDD partner institution (in China and Bangladesh), or a combination of both (in Egypt). |
Concurrent parasitic infections in a renal transplant patient
Visvesvara GS , Arrowood MJ , Qvarnstrom Y , Sriram R , Bandea R , Wilkins PP , Farnon E , Weitzman G . Emerg Infect Dis 2013 19 (12) 2044-5 Protozoan pathogens, including Entamoeba histolytica, Giardia, Cryptosporidium, Cyclospora, Cystoisospora, and microsporidia such as Enterocytozoon bieneusi, are well-known agents of diarrhea and a major public health problem in developing countries. Infection with Cyclospora cayetanensis and E. bieneusi can occur in immunocompromised and immunocompetent persons. Severe diarrhea and weight loss along with anorexia, nausea, and low-grade fever occur in immunocompromised persons, particularly those with HIV/AIDS and transplant recipients who are taking immunosuppressive drugs (1,2). However, transient diarrhea occurs in immunocompetent persons, notably in travelers returning from countries with poor hygienic standards (1–3). | | We report on a kidney transplant recipient who had uncontrollable diarrhea and weight loss in whom C. cayetanensis and E. bieneusi were detected in biopsy specimens; the diarrhea resolved after treatment with drugs that act specifically on these 2 parasites. The patient was a 55-year-old man from the Dominican Republic living in New York, NY, USA; he had a history of long-term diabetes, coronary disease, and alcoholism. He had undergone a cadaveric renal transplant 14 months earlier and had an uneventful posttransplant course. After returning from visiting family in the Dominican Republic, he sought treatment for acute, profuse watery diarrhea in early November, 2009. He had >10 watery bowel movements daily that were associated with a 20-lb weight loss. His symptoms persisted for 2 months, and he required 2 hospitalizations for the diarrhea. |
Fatal transplant-associated West Nile virus encephalitis and public health investigation-California, 2010
Rabe IB , Schwartz BS , Farnon EC , Josephson SA , Webber AB , Roberts JP , de Mattos AM , Gallay BJ , van Slyck S , Messenger SL , Yen CJ , Bloch EM , Drew CP , Fischer M , Glaser CA . Transplantation 2013 96 (5) 463-8 BACKGROUND: In December 2010, a case of West Nile virus (WNV) encephalitis occurring in a kidney recipient shortly after organ transplantation was identified. METHODS: A public health investigation was initiated to determine the likely route of transmission, detect potential WNV infections among recipients from the same organ donor, and remove any potentially infected blood products or tissues. Available serum, cerebrospinal fluid, and urine samples from the organ donor and recipients were tested for WNV infection by nucleic acid testing and serology. RESULTS: Two additional recipients from the same organ donor were identified, their clinical and exposure histories were reviewed, and samples were obtained. WNV RNA was retrospectively detected in the organ donor's serum. After transplantation, the left kidney recipient had serologic and molecular evidence of WNV infection and the right kidney recipient had prolonged but clinically inapparent WNV viremia. The liver recipient showed no clinical signs of infection but had flavivirus IgG antibodies; however, insufficient samples were available to determine the timing of infection. No remaining infectious products or tissues were identified. CONCLUSIONS: Clinicians should suspect WNV as a cause of encephalitis in organ transplant recipients and report cases to public health departments for prompt investigation of the source of infection. Increased use of molecular testing and retaining pretransplantation sera may improve the ability to detect and diagnose transplant-associated WNV infection in organ transplant recipients. |
Solid organ transplant-associated lymphocytic choriomeningitis, United States, 2011
MacNeil A , Stroher U , Farnon E , Campbell S , Cannon D , Paddock CD , Drew CP , Kuehnert M , Knust B , Gruenenfelder R , Zaki SR , Rollin PE , Nichol ST . Emerg Infect Dis 2012 18 (8) 1256-1262 Three clusters of organ transplant-associated lymphocytic choriomeningitis virus (LCMV) transmissions have been identified in the United States; 9 of 10 recipients died. In February 2011, we identified a fourth cluster of organ transplant-associated LCMV infections. Diabetic ketoacidosis developed in the organ donor in December 2010; she died with generalized brain edema after a short hospitalization. Both kidneys, liver, and lung were transplanted to 4 recipients; in all 4, severe posttransplant illness developed; 2 recipients died. Through multiple diagnostic methods, we identified LCMV infection in all persons, including in at least 1 sample from the donor and 4 recipients by reverse transcription PCR, and sequences of a 396-bp fragment of the large segment of the virus from all 5 persons were identical. In this cluster, all recipients developed severe illness, but 2 survived. LCMV infection should be considered as a possible cause of severe posttransplant illness. |
Proportion of deaths and clinical features in Bundibugyo Ebola virus infection, Uganda
Macneil A , Farnon EC , Wamala J , Okware S , Cannon DL , Reed Z , Towner JS , Tappero JW , Lutwama J , Downing R , Nichol ST , Ksiazek TG , Rollin PE . Emerg Infect Dis 2010 16 (12) 1969-1972 The first known Ebola hemorrhagic fever (EHF) outbreak caused by Bundibugyo Ebola virus occurred in Bundibugyo District, Uganda, in 2007. Fifty-six cases of EHF were laboratory confirmed. Although signs and symptoms were largely nonspecific and similar to those of EHF outbreaks caused by Zaire and Sudan Ebola viruses, proportion of deaths among those infected was lower ( approximately 40%). |
An investigation of a major outbreak of Rift Valley fever in Kenya: 2006-2007
Nguku PM , Sharif SK , Mutonga D , Amwayi S , Omolo J , Mohammed O , Farnon EC , Gould LH , Lederman E , Rao C , Sang R , Schnabel D , Feikin DR , Hightower A , Njenga MK , Breiman RF . Am J Trop Med Hyg 2010 83 5-13 An outbreak of Rift Valley fever (RVF) occurred in Kenya during November 2006 through March 2007. We characterized the magnitude of the outbreak through disease surveillance and serosurveys, and investigated contributing factors to enhance strategies for forecasting to prevent or minimize the impact of future outbreaks. Of 700 suspected cases, 392 met probable or confirmed case definitions; demographic data were available for 340 (87%), including 90 (26.4%) deaths. Male cases were more likely to die than females, Case Fatality Rate Ratio 1.8 (95% Confidence Interval [CI] 1.3-3.8). Serosurveys suggested an attack rate up to 13% of residents in heavily affected areas. Genetic sequencing showed high homology among viruses from this and earlier RVF outbreaks. Case areas were more likely than non-case areas to have soil types that retain surface moisture. The outbreak had a devastatingly high case-fatality rate for hospitalized patients. However, there were up to 180,000 infected mildly ill or asymptomatic people within highly affected areas. Soil type data may add specificity to climate-based forecasting models for RVF. |
Household-based sero-epidemiologic survey after a yellow fever epidemic, Sudan, 2005
Farnon EC , Gould LH , Griffith KS , Osman MS , Kholy AE , Brair ME , Panella AJ , Kosoy O , Laven JJ , Godsey MS , Perea W , Hayes EB . Am J Trop Med Hyg 2010 82 (6) 1146-52 From September through early December 2005, an outbreak of yellow fever (YF) occurred in South Kordofan, Sudan, resulting in a mass YF vaccination campaign. In late December 2005, we conducted a serosurvey to assess YF vaccine coverage and to better define the epidemiology of the outbreak in an index village. Of 552 persons enrolled, 95% reported recent YF vaccination, and 25% reported febrile illness during the outbreak period: 13% reported YF-like illness, 4% reported severe YF-like illness, and 12% reported chikungunya-like illness. Of 87 persons who provided blood samples, all had positive YF serologic results, including three who had never been vaccinated. There was also serologic evidence of recent or prior chikungunya virus, dengue virus, West Nile virus, and Sindbis virus infections. These results indicate that YF virus and chikungunya virus contributed to the outbreak. The high prevalence of YF antibody among vaccinees indicates that vaccination was effectively implemented in this remotely located population. |
Clinical assessment of self-reported acute flaccid paralysis in a population-based setting in Guatemala
Sejvar JJ , Lindblade KA , Arvelo W , Padilla N , Pringle K , Zielinski-Gutierrez E , Farnon E , Schonberger LB , Dueger E . Am J Trop Med Hyg 2010 82 (4) 712-6 Historically, poliovirus infection has been an important cause of acute flaccid paralysis (AFP) worldwide; however, successful elimination of wild-type poliovirus in much of the world has highlighted the importance of other causes of AFP. Despite the evolving etiology, AFP surveillance in most developing countries still focuses on poliovirus detection and fails to detect many AFP cases, particularly among adults. We assessed 41 subjects self-reporting symptoms suggestive of AFP during a population-based health survey in the Department of Santa Rosa, Guatemala. Thirty-five (85%) of the suspected cases were not hospitalized. Most subjects (37) did not have features consistent with AFP or had other diagnoses explaining weakness. We identified two adults who had not received medical attention for a clinical illness consistent with Guillain-Barre syndrome, the most important cause of non-poliovirus AFP. Usual surveillance methods for AFP, particularly in developing countries, may underestimate the true burden of non-poliovirus AFP. |
Successful immunization of an allogeneic bone marrow transplant recipient with live, attenuated yellow fever vaccine
Yax JA , Farnon EC , Cary Engleberg N . J Travel Med 2009 16 (5) 365-7 Vaccination against yellow fever is effective, but available live virus vaccines are not recommended for use in immunocompromised or elderly patients. We report the successful and uneventful immunization of a 62-year-old man with a history of allogeneic bone marrow transplant and discuss evidence for this recommendation. |
Domestically acquired Seoul virus causing hemorrhagic fever with renal syndrome-Maryland, 2008
Woods C , Palekar R , Kim P , Blythe D , de Senarclens O , Feldman K , Farnon EC , Rollin PE , Albarino CG , Nichol ST , Smith M . Clin Infect Dis 2009 49 (10) e109-12 Hantaviruses are rodent-borne viruses capable of causing human disease. The Seoul virus is a hantavirus that causes hemorrhagic fever with renal syndrome in East Asia. To our knowledge, we report the first domestically acquired case of hemorrhagic fever with renal syndrome caused by the Seoul virus, confirmed by serology testing, reverse-transcriptase polymerase chain reaction, and nucleotide sequence analysis. The patient presented with myalgias and fever, and developed acute renal failure. |
Isolation of genetically diverse Marburg viruses from Egyptian fruit bats
Towner JS , Amman BR , Sealy TK , Carroll SA , Comer JA , Kemp A , Swanepoel R , Paddock CD , Balinandi S , Khristova ML , Formenty PB , Albarino CG , Miller DM , Reed ZD , Kayiwa JT , Mills JN , Cannon DL , Greer PW , Byaruhanga E , Farnon EC , Atimnedi P , Okware S , Katongole-Mbidde E , Downing R , Tappero JW , Zaki SR , Ksiazek TG , Nichol ST , Rollin PE . PLoS Pathog 2009 5 (7) e1000536 In July and September 2007, miners working in Kitaka Cave, Uganda, were diagnosed with Marburg hemorrhagic fever. The likely source of infection in the cave was Egyptian fruit bats (Rousettus aegyptiacus) based on detection of Marburg virus RNA in 31/611 (5.1%) bats, virus-specific antibody in bat sera, and isolation of genetically diverse virus from bat tissues. The virus isolates were collected nine months apart, demonstrating long-term virus circulation. The bat colony was estimated to be over 100,000 animals using mark and re-capture methods, predicting the presence of over 5,000 virus-infected bats. The genetically diverse virus genome sequences from bats and miners closely matched. These data indicate common Egyptian fruit bats can represent a major natural reservoir and source of Marburg virus with potential for spillover into humans. |
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