Last data update: Nov 04, 2024. (Total: 48056 publications since 2009)
Records 1-30 (of 72 Records) |
Query Trace: Hertz M[original query] |
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Alignment of parent-proxy report and teen self-report of adverse childhood experiences among U.S. teens
Licitis L , Suarez N , Anderson KN , Hertz MF , Verlenden J , Viox MH , Pampati S . Ann Epidemiol 2024 PURPOSE: Data on adverse childhood experiences (ACEs) among teens is collected using a single informant, a parent-proxy, or teen self-report. Little is known about alignment between these approaches. METHODS: Surveys were administered online to teens ages 15-17 and their parents (n=522 dyads) using the AmeriSpeak panel. We present descriptive statistics on the prevalence and measures agreement for 18 ACEs based on teen self-report and parent-proxy report. We fit multivariable models examining associations between teen and household demographic characteristics and discordance in ACE report. RESULTS: Based on teen-self report and parent-proxy report, cumulative and individual ACE prevalence was overall similar. However, discordance was found in individual ACE reports within teen-parent dyads (discordance ranged: 2.9% - 21.2%). Lowest agreement was among ACEs related to abuse, neglect, and violence victimization and highest among household challenges. Furthermore, parent-teen dyads with LGB+ youth (vs. heterosexual) and Black, Hispanic, and multiracial or another race (vs. White) youth were more likely to have discordant responses among several ACEs. CONCLUSIONS: Surveillance and programmatic efforts should consider the type of ACE and the reporter when using data to inform prevention strategies. Teen self-report for abuse, neglect, and violence victimization and community challenges ACEs are particularly important to capture. |
Exposure to endocrine disrupting chemicals including phthalates, phenols, and parabens in infancy: Associations with neurodevelopmental outcomes in the MARBLES study
Sotelo-Orozco J , Calafat AM , Cook Botelho J , Schmidt RJ , Hertz-Picciotto I , Bennett DH . Int J Hyg Environ Health 2024 261 114425 BACKGROUND: Endocrine disrupting chemicals (EDCs) are widely used compounds with the potential to affect child neurodevelopmental outcomes including autism spectrum disorders (ASD). We aimed to examine the urinary concentrations of biomarkers of EDCs, including phthalates, phenols, and parabens, and investigate whether exposure during early infancy was associated with increased risk of later ASD or other non-typical development (Non-TD) or adverse cognitive development. METHODS: This analysis included infants from the Markers of Autism Risks in Babies-Learning Early Signs (MARBLES) study, a high-risk ASD cohort (n = 148; corresponding to 188 urine samples). Thirty-two EDC biomarkers were quantified in urine among infants 3 and/or 6 months of age. Trends in EDC biomarker concentrations were calculated using least square geometric means. At 36 months of age, children were clinically classified as having ASD (n = 36), nontypical development (Non-TD; n = 18), or typical development (TD; n = 81) through a clinical evaluation. Trinomial logistic regression analysis was used to test the associations between biomarkers with ASD, or Non-TD, as compared to children with TD. In single analyte analysis, generalized estimating equations were used to investigate the association between each EDC biomarkers and longitudinal changes in cognitive development using the Mullen Scales of Early Learning (MSEL) over the four assessment time points (6, 12, 24, and 36 months of age). Additionally, quantile g-computation was used to test for a mixture effect. RESULTS: EDC biomarker concentrations generally decreased over the study period, except for mono-2-ethyl-5-carboxypentyl terephthalate. Overall, EDC biomarkers at 3 and/or 6 months of age were not associated with an increased risk of ASD or Non-TD, and a few showed significant inverse associations. However, when assessing longitudinal changes in MSEL scores over the four assessment time points, elevated monoethyl phthalate (MEP) was significantly associated with reduced scores in the composite score (β = -0.16, 95% CI: 0.31, -0.02) and subscales of fine motor skills (β = -0.09, 95%CI: 0.17, 0.00), and visual reception (β = -0.11, 95% CI: 0.23, 0.01). Additionally, the sum of metabolites of di (2-ethylhexyl) terephthalate (ƩDEHTP) was associated with poorer visual reception (β = -0.09, 95% CI: 0.16, -0.02), and decreased composite scores (β = -0.11, 95% CI: 0.21, -0.01). Mixtures analyses using quantile g-computation analysis did not show a significant association between mixtures of EDC biomarkers and MSEL subscales or composite scores. CONCLUSION: These findings highlight the potential importance of infant exposures on cognitive development. Future research can help further investigate whether early infant exposures are associated with longer-term deficits and place special attention on EDCs with increasing temporal trends and whether they may adversely affect neurodevelopment. |
Associations between exposure to school violence and weapon-carrying at school
Lowry R , Parker EM , Ratto JD , Krause K , Hertz MF . Am J Prev Med 2023 65 (3) 347-355 INTRODUCTION: Among U.S. high-school students, interpersonal violence and victimizations often occur on school property. The presence of a weapon can increase the potential for injury and death resulting from interpersonal conflict. This study examines the associations between exposure to school violence and weapon carrying on school property among U.S. high-school students. METHODS: Data from the 2017 and 2019 national Youth Risk Behavior Surveys were combined (N=28,442) and analyzed in 2022. Multivariable logistic regression models were used to calculate sex-stratified, adjusted (for race/ethnicity, grade, sexual identity, current substance use, suicidal thoughts, and history of concussion) prevalence ratios. Prevalence ratios were considered statistically significant if 95% CIs did not include 1.0. RESULTS: Male students (4.7%) were more likely than female students (1.8%) to report carrying a weapon at school during the 30 days preceding the survey. Weapon carrying at school was more prevalent among students who were threatened or injured with a weapon at school (male students, adjusted prevalence ratio=3.45; female students, adjusted prevalence ratio=3.90), among students who were involved in a physical fight at school (male students, adjusted prevalence ratio=3.44; female students, adjusted prevalence ratio=3.72), among students who missed school because they did not feel safe (male students, adjusted prevalence ratio=1.98; female students, adjusted prevalence ratio=2.97), and among male students who were bullied at school (adjusted prevalence ratio=1.72) than among students who did not experience school violence. CONCLUSIONS: Increased emphasis on safe and supportive school environments, where all types of interpersonal violence are less likely to occur, and increased access to programs and services to promote mental health, prevent violence, and deter weapon use are needed. |
Witnessing community violence, gun carrying, and associations with substance use and suicide risk among high school students - Youth Risk Behavior Survey, United States, 2021
Harper CR , Li J , Sheats K , Hertz MF , Merrill-Francis M , Friar NW , Ashley CL , Shanklin S , Barbero C , Gaylor EM , Hoots BE . MMWR Suppl 2023 72 (1) 22-28 Community violence, including homicides involving firearms, is a significant public health concern. From 2019 to 2020, firearm-related homicides increased by 39% for youths and young adults aged 10-24 years, and rates of suicide by firearm increased by approximately 15% among the same age group. Findings from the nationally representative 2021 Youth Risk Behavior Survey were used to analyze disparities and correlates of witnessing community violence and gun carrying among a nationally representative sample of high school students. Chi-square tests and logistic regression accounting for the complex sampling of the survey were used to assess demographic differences by student sex, race and ethnicity, age, and sexual identity in ever witnessing community violence, gun carrying in the past 12 months, and their associations with substance use and suicide risk. Measures of substance use included current binge drinking and marijuana use and lifetime prescription opioid misuse and illicit drug use. Suicide risk included seriously considered attempting suicide and attempted suicide in the past 12 months. Overall, approximately 20% of students witnessed community violence and 3.5% of students carried a gun. American Indian or Alaska Native, Black, and Hispanic students were more likely to witness community violence and to report carrying a gun than their White peers. Males were more likely to witness community violence and carry a gun than females. Lesbian, gay, or bisexual students were more likely to witness community violence than their heterosexual peers. Also, witnessing community violence consistently was associated with increased odds of gun carrying, substance use, and suicide risk for both males and females and when comparing Black, White, and Hispanic students. These findings highlight the importance of comprehensive violence prevention strategies that incorporate health equity to mitigate the effects of violence exposure on substance use and suicide risk among youths. |
Prescription opioid misuse and use of alcohol and other substances among high school students - Youth Risk Behavior Survey, United States, 2019
Jones CM , Clayton HB , Deputy NP , Roehler DR , Ko JY , Esser MB , Brookmeyer KA , Hertz MF . MMWR Suppl 2020 69 (1) 38-46 Adolescence is an important period of risk for substance use initiation and substance use-related adverse outcomes. To examine youth substance use trends and patterns, CDC analyzed data from the 2009-2019 Youth Risk Behavior Survey. This report presents estimated prevalence of current (i.e., previous 30-days) marijuana use, prescription opioid misuse, alcohol use, and binge drinking and lifetime prevalence of marijuana, synthetic marijuana, cocaine, methamphetamine, heroin, injection drug use, and prescription opioid misuse among U.S. high school students. Logistic regression and Joinpoint analyses were used to assess 2009-2019 trends. Prevalence of current and lifetime substance use by demographics, frequency of use, and prevalence of co-occurrence of selected substances among students reporting current prescription opioid misuse are estimated using 2019 data. Multivariable logistic regression analysis was used to determine demographic and substance use correlates of current prescription opioid misuse. Current alcohol, lifetime cocaine, methamphetamine, heroin, and injection drug use decreased during 2009-2019. Lifetime use of synthetic marijuana (also called synthetic cannabinoids) decreased during 2015-2019. Lifetime marijuana use increased during 2009-2013 and then decreased during 2013-2019. In 2019, 29.2% reported current alcohol use, 21.7% current marijuana use, 13.7% current binge drinking, and 7.2% current prescription opioid misuse. Substance use varied by sex, race/ethnicity, grade, and sexual minority status (lesbian, gay, or bisexual). Use of other substances, particularly current use of alcohol (59.4%) and marijuana (43.5%), was common among students currently misusing prescription opioids. Findings highlight opportunities for expanding evidence-based prevention policies, programs, and practices that aim to reduce risk factors and strengthen protective factors related to youth substance use, in conjunction with ongoing initiatives for combating the opioid crisis. |
Mental health, suicidality, and connectedness among high school students during the COVID-19 pandemic - Adolescent Behaviors and Experiences Survey, United States, January-June 2021
Jones SE , Ethier KA , Hertz M , DeGue S , Le VD , Thornton J , Lim C , Dittus PJ , Geda S . MMWR Suppl 2022 71 (3) 16-21 Disruptions and consequences related to the COVID-19 pandemic, including school closures, social isolation, family economic hardship, family loss or illness, and reduced access to health care, raise concerns about their effects on the mental health and well-being of youths. This report uses data from the 2021 Adolescent Behaviors and Experiences Survey, an online survey of a probability-based, nationally representative sample of U.S. public- and private-school students in grades 9-12 (N = 7,705), to assess U.S. high school students' mental health and suicidality during the COVID-19 pandemic. The study also examines whether mental health and suicidality are associated with feeling close to persons at school and being virtually connected to others during the pandemic. Overall, 37.1% of students experienced poor mental health during the pandemic, and 31.1% experienced poor mental health during the preceding 30 days. In addition, during the 12 months before the survey, 44.2% experienced persistent feelings of sadness or hopelessness, 19.9% had seriously considered attempting suicide, and 9.0% had attempted suicide. Compared with those who did not feel close to persons at school, students who felt close to persons at school had a significantly lower prevalence of poor mental health during the pandemic (28.4% versus 45.2%) and during the past 30 days (23.5% versus 37.8%), persistent feelings of sadness or hopelessness (35.4% versus 52.9%), having seriously considered attempting suicide (14.0% versus 25.6%), and having attempted suicide (5.8% versus 11.9%). The same pattern was observed among students who were virtually connected to others during the pandemic (i.e., with family, friends, or other groups by using a computer, telephone, or other device) versus those who were not. Comprehensive strategies that improve feelings of connectedness with others in the family, in the community, and at school might foster improved mental health among youths during and after the COVID-19 pandemic. |
Alcohol and other substance use before and during the COVID-19 pandemic among high school students - Youth Risk Behavior Survey, United States, 2021
Hoots BE , Li J , Hertz MF , Esser MB , Rico A , Zavala EY , Jones CM . MMWR Suppl 2023 72 (1) 84-92 Adolescence is a critical phase of development and is frequently a period of initiating and engaging in risky behaviors, including alcohol and other substance use. The COVID-19 pandemic and associated stressors might have affected adolescent involvement in these behaviors. To examine substance use patterns and understand how substance use among high school students changed before and during the COVID-19 pandemic, CDC analyzed data from the nationally representative Youth Risk Behavior Survey. This report presents estimated prevalences among high school students of current (i.e., previous 30 days) alcohol use, marijuana use, binge drinking, and prescription opioid misuse and lifetime alcohol, marijuana, synthetic marijuana, inhalants, ecstasy, cocaine, methamphetamine, heroin, and injection drug use and prescription opioid misuse. Trends during 2009-2021 were assessed using logistic regression and joinpoint regression analyses. Changes in substance use from 2019 to 2021 were assessed using prevalence differences and prevalence ratios, stratified by demographic characteristics. Prevalence of substance use measures by sexual identity and current co-occurring substance use were estimated using 2021 data. Substance use prevalence declined during 2009-2021. From 2019 to 2021, the prevalence of current alcohol use, marijuana use, and binge drinking and lifetime use of alcohol, marijuana, and cocaine and prescription opioid misuse decreased; lifetime inhalant use increased. In 2021, substance use varied by sex, race and ethnicity, and sexual identity. Approximately one third of students (29%) reported current use of alcohol or marijuana or prescription opioid misuse; among those reporting current substance use, approximately 34% used two or more substances. Widespread implementation of tailored evidence-based policies, programs, and practices likely to reduce risk factors for adolescent substance use and promote protective factors might further decrease substance use among U.S. high school students and is urgently needed in the context of the changing marketplaces for alcohol beverage products and other drugs (e.g., release of high-alcohol beverage products and increased availability of counterfeit pills containing fentanyl). |
Per- and polyfluoroalkyl substances (PFAS) in serum of 2 to 5 year-old children: Temporal trends, determinants, and correlations with maternal PFAS concentrations
Oh J , Shin HM , Kannan K , Calafat AM , Schmidt RJ , Hertz-Picciotto I , Bennett DH . Environ Sci Technol 2024 Young children may experience higher per- and polyfluoroalkyl substances (PFAS) exposure than adults due to breastfeeding, higher dust ingestion rates, and frequent hand-to-mouth activities. We explored temporal trends and determinants of child serum PFAS concentrations and their correlations with paired maternal PFAS concentrations. From 2009 to 2017, we collected one blood sample from each of 541 children aged 2-5 years participating in the Childhood Autism Risks from Genetics and Environment (CHARGE) study and quantified 14 PFAS in serum. For nine frequently detected PFAS (>65% of samples), we performed multiple regression adjusting for potential determinants to estimate mean percent concentration changes. For a subset of 327 children, we also quantified nine PFAS in their mother's serum collected at the same visit and computed Spearman correlation coefficients (r(sp)) between maternal and child PFAS concentrations. During 2009-2017, child serum concentrations of all nine PFAS decreased by 6-25% annually. Several PFAS concentrations were higher among non-Hispanic white children and those with highly educated parents. Most maternal and child PFAS concentrations were moderately correlated (r(sp) = 0.13-0.39), with a strong correlation for N-methyl perfluorooctane sulfonamido acetic acid (r(sp) = 0.68). Breastfeeding duration appeared to contribute to higher child and lower maternal PFAS concentrations, resulting in relatively weak correlations between maternal and child PFAS concentrations for samples collected in early childhood. Considering that more than half of our study children had neurodevelopmental concerns, the generalizability of our findings might be limited. |
The medications for opioid use disorder study: Methods and initial outcomes from an 18-month study of patients in treatment for opioid use disorder
Dever JA , Hertz MF , Dunlap LJ , Richardson JS , Wolicki SB , Biggers BB , Edlund MJ , Bohm MK , Turcios D , Jiang X , Zhou H , Evans ME , Guy GP Jr . Public Health Rep 2024 333549231222479 OBJECTIVE: Opioid use disorder (OUD) affects approximately 5.6 million people in the United States annually, yet rates of the use of effective medication for OUD (MOUD) treatment are low. We conducted an observational cohort study from August 2017 through May 2021, the MOUD Study, to better understand treatment engagement and factors that may influence treatment experiences and outcomes. In this article, we describe the study design, data collected, and treatment outcomes. METHODS: We recruited adult patients receiving OUD treatment at US outpatient facilities for the MOUD Study. We collected patient-level data at 5 time points (baseline to 18 months) via self-administered questionnaires and health record data. We collected facility-level data via questionnaires administered to facility directors at 2 time points. Across 16 states, 62 OUD treatment facilities participated, and 1974 patients enrolled in the study. We summarized descriptive data on the characteristics of patients and OUD treatment facilities and selected treatment outcomes. RESULTS: Approximately half of the 62 facilities were private, nonprofit organizations; 62% focused primarily on substance use treatment; and 20% also offered mental health services. Most participants were receiving methadone (61%) or buprenorphine (32%) and were predominately non-Hispanic White (68%), aged 25-44 years (62%), and female (54%). Compared with patient-reported estimates at baseline, 18-month estimates suggested that rates of abstinence increased (55% to 77%), and rates of opioid-related overdoses (7% to 2%), emergency department visits (9% to 4%), and arrests (15% to 7%) decreased. CONCLUSIONS: Our results demonstrated the benefits of treatment retention not only on abstinence from opioid use but also on other quality-of-life metrics, with data collected during an extended period. The MOUD Study produced rich, multilevel data that can lay the foundation for an evidence base to inform OUD treatment and support improvement of care and patient outcomes. |
Racial and ethnic disparities in phthalate exposure and preterm birth: A pooled study of sixteen U.S. Cohorts
Welch BM , Keil AP , Buckley JP , Engel SM , James-Todd T , Zota AR , Alshawabkeh AN , Barrett ES , Bloom MS , Bush NR , Cordero JF , Dabelea D , Eskenazi B , Lanphear BP , Padmanabhan V , Sathyanarayana S , Swan SH , Aalborg J , Baird DD , Binder AM , Bradman A , Braun JM , Calafat AM , Cantonwine DE , Christenbury KE , Factor-Litvak P , Harley KG , Hauser R , Herbstman JB , Hertz-Picciotto I , Holland N , Jukic AMZ , McElrath TF , Meeker JD , Messerlian C , Michels KB , Newman RB , Nguyen RHN , O'Brien KM , Rauh VA , Redmon B , Rich DQ , Rosen EM , Schmidt RJ , Sparks AE , Starling AP , Wang C , Watkins DJ , Weinberg CR , Weinberger B , Wenzel AG , Wilcox AJ , Yolton K , Zhang Y , Ferguson KK . Environ Health Perspect 2023 131 (12) 127015 BACKGROUND: Phthalate exposures are ubiquitous during pregnancy and may contribute to racial and ethnic disparities in preterm birth. OBJECTIVES: We investigated race and ethnicity in the relationship between biomarkers of phthalate exposure and preterm birth by examining: a) how hypothetical reductions in racial and ethnic disparities in phthalate metabolites might reduce the probability of preterm birth; and b) exposure-response models stratified by race and ethnicity. METHODS: We pooled individual-level data on 6,045 pregnancies from 16 U.S. cohorts. We investigated covariate-adjusted differences in nine urinary phthalate metabolite concentrations by race and ethnicity [non-Hispanic White (White, 43%), non-Hispanic Black (Black, 13%), Hispanic/Latina (38%), and Asian/Pacific Islander (3%)]. Using g-computation, we estimated changes in the probability of preterm birth under hypothetical interventions to eliminate disparities in levels of urinary phthalate metabolites by proportionally lowering average concentrations in Black and Hispanic/Latina participants to be approximately equal to the averages in White participants. We also used race and ethnicity-stratified logistic regression to characterize associations between phthalate metabolites and preterm birth. RESULTS: In comparison with concentrations among White participants, adjusted mean phthalate metabolite concentrations were consistently higher among Black and Hispanic/Latina participants by 23%-148% and 4%-94%, respectively. Asian/Pacific Islander participants had metabolite levels that were similar to those of White participants. Hypothetical interventions to reduce disparities in metabolite mixtures were associated with lower probabilities of preterm birth for Black [13% relative reduction; 95% confidence interval (CI): - 34%, 8.6%] and Hispanic/Latina (9% relative reduction; 95% CI: - 19%, 0.8%) participants. Odds ratios for preterm birth in association with phthalate metabolites demonstrated heterogeneity by race and ethnicity for two individual metabolites (mono-n-butyl and monoisobutyl phthalate), with positive associations that were larger in magnitude observed among Black or Hispanic/Latina participants. CONCLUSIONS: Phthalate metabolite concentrations differed substantially by race and ethnicity. Our results show hypothetical interventions to reduce population-level racial and ethnic disparities in biomarkers of phthalate exposure could potentially reduce the probability of preterm birth. https://doi.org/10.1289/EHP12831. |
Disparities and trends in middle school students' suicidal thoughts and behaviors: Results from the Youth Risk Behavior Survey, 2015-2019
Young E , Szucs LE , Suarez NA , Wilkins NJ , Hertz M , Ivey-Stephenson A . J Adolesc Health 2023 PURPOSE: To examine trends and racial and ethnic disparities in early adolescent suicidal thoughts and behaviors in the years immediately prior to the COVID-19 pandemic. METHODS: This study used pooled data from Centers for Disease Control and Prevention's middle school Youth Risk Behavior Survey (n = 127,912) between 2015 and 2019. Three dichotomized measures of suicide-related behaviors were assessed: suicidal thoughts, planning, and attempts. Weighted prevalence estimates with 95% confidence intervals were calculated for each survey year. Linear trends examined disparities in the prevalence of suicidal thoughts and behaviors, overall and by student demographic characteristics. Main effects odds ratios compared estimates among racial and ethnic minority adolescents with non-Hispanic White students, controlling for sex and grade. RESULTS: Significant linear increases were observed for the percentage of middle school students who reported seriously thinking about suicide (18.2%-22.3%), ever making a suicide plan (11.8%-14.7%), and ever attempting suicide (6.9%-9.3%). Racial and ethnic minority students, other than non-Hispanic Asian, showed higher odds of suicidal thoughts and behaviors compared with non-Hispanic White students. DISCUSSION: Findings indicate a need for comprehensive suicide prevention to address health equity and disparities in suicide-related behaviors among middle school-aged adolescents. |
Children's mental health during the COVID-19 pandemic: a population-based cohort study in the United States
Pampati S , Verlenden JV , Cree RA , Hertz M , Bitsko RH , Spencer P , Moore S , Michael SL , Dittus PJ . Ann Epidemiol 2023 88 7-14 PURPOSE: Examine children's mental health symptoms, including changes during the COVID-19 pandemic. METHODS: The COVID Experiences Surveys, designed to be representative of the U.S. household population, were administered online to parents of children aged 5-12 years (Wave 1, Oct-Nov 2020, n=1561; Wave 2, March-May 2021, n=1287). We modeled changes in children's symptoms of anxiety, depression, and psychological stress and examined associations between demographic characteristics, COVID-19 related experiences, and protective factors with symptoms across both waves using generalized estimating equations. RESULTS: Based on parent-report, children's symptoms of anxiety and depression decreased from W1 to W2 (Δ t-score anxiety = -1.8 [95% CI: -2.5, -1.0]; Δ t-score depression = -1.0 [CI: -1.7, -0.3]). Psychological stress remained consistent. Across waves, older children and children with an emotional, mental, developmental, behavioral, physical, or medical condition were more likely to have specific poor mental health symptoms. Poor mental health symptoms were more likely among children with several contextual stressors (e.g., economic stress, parental emotional strain) and less likely among children with protective factors (e.g., daily routines, neighborhood cohesion). CONCLUSIONS: Establishing programs that support mental health, improving access to mental health services, and fostering collaborations to advance children's mental health is important. |
Evaluation of low-frequency noise, infrasound, and health symptoms at an administrative building and men's shelter: A case study
Chiu SK , Brueck SE , Wiegand DM , Free HL , Echt H . Semin Hear 2023 44 (4) 503-520 Responses to complaints about low-frequency noise and infrasound at workplaces have not been extensively documented in the literature. The National Institute for Occupational Safety and Health evaluated low-frequency noise, infrasound, and health symptoms among employees of an organization providing services to homeless persons. The organization's campus was evacuated after two loud noise and vibration incidents related to methane flare on an adjacent landfill. Employees were interviewed about health symptoms, perceptions of noise, and how the incidents were handled. Available medical records were reviewed. Sound level and noise frequency measurements taken in vacated campus buildings not during these incidents revealed overall levels across frequencies up to 100 hertz were 64 to 73 dB, well below those associated with adverse health effects. However, an unbalanced frequency spectrum could have contributed to the unusual sounds or vibrations reported before the first incident. Some symptoms predating the incidents are consistent with low-frequency noise exposure but are also common and nonspecific. Most interviewed employees (57%) reported being uncomfortable returning to work on the campus. Multiple factors such as noise characteristics, health effects, and employee perceptions need to be considered when assessing health concerns related to low-frequency noise and infrasound. |
Design and implementation of an innovative, rapid data-monitoring strategy for public health emergencies: Pilot of the United States school COVID-19 Mitigation Strategies Project
Hertz MF , Dierst-Davies R , Freire K , Verlenden JMV , Whitton L , Zimmerman J , Honeycutt S , Puddy R , Baldwin GT . Public Health Rep 2023 138 (6) 333549231190050 During the COVID-19 pandemic, an urgent need existed for near-real-time data collection to better understand how individual beliefs and behaviors, state and local policies, and organizational practices influenced health outcomes. We describe the processes, methods, and lessons learned during the development and pilot testing of an innovative rapid data collection process we developed to inform decision-making during the COVID-19 public health emergency. We used a fully integrated mixed-methods approach to develop a structured process for triangulating quantitative and qualitative data from traditional (cross-sectional surveys, focus groups) and nontraditional (social media listening) sources. Respondents included students, parents, teachers, and key school personnel (eg, nurses, administrators, mental health providers). During the pilot phase (February-June 2021), data from 12 cross-sectional and sector-based surveys (n = 20 302 participants), 28 crowdsourced surveys (n = 26 820 participants), 10 focus groups (n = 64 participants), and 11 social media platforms (n = 432 754 503 responses) were triangulated with other data to support COVID-19 mitigation in schools. We disseminated findings through internal dashboards, triangulation reports, and policy briefs. This pilot demonstrated that triangulating traditional and nontraditional data sources can provide rapid data about barriers and facilitators to mitigation implementation during an evolving public health emergency. Such a rapid feedback and continuous improvement model can be tailored to strengthen response efforts. This approach emphasizes the value of nimble data modernization efforts to respond in real time to public health emergencies. |
The school environment and physical and social-emotional well-being: Implications for students and school employees
Hawkins GT , Chung CS , Hertz MF , Antolin N . J Sch Health 2023 93 (9) 799-812 BACKGROUND: The school environment, consisting of the physical environment and social-emotional climate (SEC), plays a crucial role in both student and employee health; however, there is a lack of recent literature synthesizing school environment interventions in K-12 settings. We describe updated evidence about school environment interventions to support K-12 student and employee health in the United States. METHODS: A 2-phase search included a review of reviews (2010-2018), followed by a search for individual articles (2010-2020) that targeted school physical environment and/or SEC to address physical activity (PA) and/or nutrition. We also investigated how nutrition and PA interventions with an SEC component improves social-emotional and/or mental health outcomes. Because research on dietary and PA behaviors for school employees is limited; we included studies on other worksites (eg, hospitals and offices) to provide insight for school employees. FINDINGS: We identified 40 articles describing 40 unique studies and 45 interventions and grouped them by intervention type. Physical environment interventions demonstrated significant and positive nutrition and PA behavioral outcomes for students; outcomes among employees were mixed. Interventions with SEC components reported improvements in some mental health outcomes. IMPLICATIONS: The school environment can affect dietary and PA behaviors as well as mental health for students and employees. CONCLUSIONS: Establishing healthy school environments can support student and employee PA, dietary behaviors, and mental health. |
Bullying victimization and associations with substance use among US middle school students: 2019 Youth Risk Behavior Survey
Barbero C , Vagi KJ , Clayton H , Holland K , Hertz M , Krause KH , Brittingham R , Bunge S , Saka SM , Marchessault N , Hynes N , Green D , Spell L , Monteiro K , Murray K , Reilly-Chammat R , Tignor L , Mercado MC . J Sch Health 2023 93 (12) 1111-1118 BACKGROUND: Research shows associations between bullying victimization and substance use for teens. However, more research about this relationship for younger adolescents and across race/ethnicity is needed. METHODS: Prevalence and pooled logistic regression analyses of 2019 Middle School Youth Risk Behavior Survey data from 13 states (N = 74,059 students) examined associations between self-reported bulling victimization (at school, electronically, and both) and having ever tried cigarette smoking, alcohol, or marijuana; used an electronic vapor product; or misused prescription pain medicine. Regression analyses were adjusted by age and sex/race/ethnicity. RESULTS: All 3 measures of bullying victimization were significantly associated (p < .05) with the 5 substance use behaviors examined (adjusted prevalence ratios ranged from 1.29 to 2.32). These associations held across sexes. Significant associations were found within all 7 race/ethnicity categories, with the most associations reported for the non-Hispanic (NH) white, NH black or African American, Hispanic/Latino, and NH Asian groups. CONCLUSION: The association between bullying and substance use by middle school is a highly relevant issue to consider as students return to classrooms. |
Disparities in the implementation of school-based mental health supports among K-12 public schools
Moore S , Timpe Z , Rasberry CN , Hertz M , Verlenden J , Spencer P , Murray C , Lee S , Barrios LC , Tripathi T , McConnell L , Iachan R , Pampati S . Psychiatr Serv 2023 75 (1) appips20220558 OBJECTIVE: The authors sought to explore the availability of mental health supports within public schools during the COVID-19 pandemic by using survey data from a nationally representative sample of U.S. K-12 public schools collected in October-November 2021. METHODS: The prevalence of 11 school-based mental health supports was examined within the sample (N=437 schools). Chi-square tests and adjusted logistic regression models were used to identify associations between school-level characteristics and mental health supports. School characteristics included level (elementary, middle, or high school), locale (city, town, suburb, or rural area), poverty level, having a full-time school nurse, and having a school-based health center. RESULTS: Universal mental health programs were more prevalent than more individualized and group-based supports (e.g., therapy groups); however, prevalence of certain mental health supports was low among schools (e.g., only 53% implemented schoolwide trauma-informed practices). Schools having middle to high levels of poverty or located in rural areas or towns and elementary schools and schools without a health infrastructure were less likely to implement mental health supports, even after analyses were adjusted for school-level characteristics. For example, compared with low-poverty schools, mid-poverty schools had lower odds of implementing prosocial skills training for students (adjusted OR [AOR]=0.49, 95% CI=0.27-0.88) and providing confidential mental health screening (AOR=0.42, 95% CI=0.22-0.79). CONCLUSIONS: Implementation levels of school-based mental health supports leave substantial room for improvement, and numerous disparities existed by school characteristics. Higher-poverty areas, schools in rural areas or towns, and elementary schools and schools without a health infrastructure may require assistance in ensuring equitable access to mental health supports. |
Adverse childhood experiences among US adolescents over the course of the COVID-19 pandemic
Hertz M , Heim Viox M , Massetti GM , Anderson KN , Bacon S , Fordyce E , Mercado MC , Verlenden JV . Pediatrics 2023 151 (6) BACKGROUND AND OBJECTIVE: A national, longitudinal survey of US adolescents assessed adverse childhood experiences (ACEs) twice during the COVID-19 pandemic. Adolescents with more Wave 1 ACEs were expected to be more likely to experience additional ACEs at Wave 2. METHODS: Adolescents aged 13 to 18 (n = 727, Fall 2020; n = 569, Spring 2021) recruited via a national, probability-based panel (survey completion rate Wave 1, 62.1%; Wave 2, 78.3%) responded to questions about household challenges, violence or neglect, and community ACE exposure at Wave 1 and Wave 2 (since Wave 1). Unweighted frequencies and 95% confidence intervals of demographic characteristics and individual ACEs were calculated by using weighted data. Odds ratios examined associations between ACEs by Wave 1 and Wave 2. RESULTS: Among respondents of both survey waves (n = 506), 27.2% experienced violence or abuse, 50.9% experienced a household challenge, and 34.9% experienced a community ACE by Wave 1. By Wave 2, 17.6% experienced 1 new ACE, 6.1% experienced 2 new ACEs and 2.7% experienced 4 or more new ACEs. Those with ≥4 ACEs by Wave 1 were 2.71 times as likely as those with none to report a new ACE at Wave 2 (confidence interval: 1.18-6.24). CONCLUSIONS: This nationwide, longitudinal study of US adolescents measured exposure to ACEs early in and during the COVID-19 pandemic. Nearly one-third of adolescents experienced a new ACE between survey waves. Prevention and trauma-informed approaches in clinical, school, and community settings may be helpful. |
Parental occupational exposure to solvents and autism spectrum disorder: An exploratory look at gene-environment interactions.
McCanlies EC , Gu JK , Kashon M , Yucesoy B , Ma CC , Sanderson WT , Kim K , Ludeña-Rodriguez YJ , Hertz-Picciotto I . Environ Res 2023 228 115769 Few studies have evaluated gene-environment interaction in the risk of autism spectrum disorder (ASD). | | • | Single nucleotide polymorphism (SNPs) in relevant genes (e.g. immune, inflammatory, serotonin) were analyzed. | | • | Two experienced industrial hygienists estimated parental occupational exposure to solvents. | | • | Additive and multiplicative gene-environment interactions between SNPs and parental solventexposure were evaluated. | | • | SNP x solvent interaction is associated with higher rates of ASD compared to the SNP alone or solvent exposure alone. |
Association between adolescent self-reported physical activity behaviors and feeling close to people at school during the COVID-19 pandemic
Michael SL , Li J , Sliwa S , Cornett K , Hertz M . Am J Lifestyle Med 2023 The disruption of school operations and routines caused by the COVID-19 pandemic affected students’ physical and emotional well-being. Providing physical activity opportunities in schools can encourage students to positively engage with each other. Using a nationally representative sample of U.S. high school students from the Adolescent Behaviors and Experiences Survey (January to June 2021), we examined the association between physical activity behaviors and feeling close to people at school using sex-stratified and race/ethnicity-stratified multiple linear regressions models. Participating in team sports, being more physically active, and attending physical education (PE) during an average week were all associated with higher levels of feeling close to people at school, with variation by sex and race/ethnicity. These associations were also significant when the physical activity behavior variables were categorized to reflect national recommendations. Daily physical activity (i.e., ≥60 minutes all 7 days), daily PE (i.e., attended all 5 days), and the number of Comprehensive School Physical Activity Program (CSPAP) components implemented were associated with higher levels of feeling close to people at school. These findings suggest that opportunities for physical activity before, during, and after school are associated with increased levels of feeling close to people at school during crises like COVID-19. © Copyright 2023 The Author(s). |
Health-risk behaviors and experiences among Asian American and native Hawaiian/Pacific Islander adolescents in the United States, 2011-2019
Swaminath M , Clayton HB , Lowry R , Hertz M , Underwood JM . Public Health Rep 2023 138 (6) 333549221137325 OBJECTIVES: Understanding the health-risk behaviors of racial and ethnic groups when disaggregated is an important step in improving the health outcomes of racial and ethnic minority groups. We compared national prevalence estimates for selected health-risk behaviors and experiences of Asian American and Native Hawaiian/Pacific Islander (NHPI) students with those of non-Hispanic White, non-Hispanic Black, and Hispanic students. METHODS: We analyzed data from the Youth Risk Behavior Survey, a nationally representative survey of US high school students. To generate a sufficient sample of Asian American and NHPI students for analyses, we combined data from 5 survey administrations, conducted in 2011, 2013, 2015, 2017, and 2019 (N = 73 074). We calculated the prevalence and 95% CIs; we analyzed data on Asian American and NHPI adolescents separately to unmask important differences. RESULTS: Compared with students of other races and ethnicities, Asian American students had the lowest prevalence of alcohol use (16.7%) and marijuana use (10.3%). In contrast, NHPI students were more likely than Asian American students to participate in several health-risk behaviors and experiences, such as substance use (ranging from 4.8% for ever injecting an illegal drug to 31.5% for current alcohol use), having been in a physical fight (15.4%), and having been threatened or injured with a weapon (11.6%). Differential patterns in the prevalence of ever having missed school due to feeling unsafe among NHPI and Asian American students were observed among male and female students. CONCLUSION: Further disaggregating racial subgroups within broad categories of Asian American and NHPI populations may reveal differences from overall group prevalence, and additional strategies to identify these differences should be investigated. |
Associations between Adverse Childhood Experiences and Pandemic-Related Stress and the Impact on Adolescent Mental Health during the COVID-19 Pandemic.
Verlenden J , Kaczkowski W , Li J , Hertz M , Anderson KN , Bacon S , Dittus P . J Child Adolesc Trauma 2022 1-15 Vulnerabilities of adolescents during times of crisis have been previously identified, but little research has investigated the compounding effects of lifetime adversities and pandemic-related stress on adolescent mental health. This study uses adolescent self-report data to model relationships between stress exposures and indicators of poor mental health from the longitudinal COVID Experiences (CovEx) Surveys. These surveys were administered online in English to U.S. adolescents ages 13-19 using the NORC AmeriSpeak panel, a probability-based panel designed to be representative of the U.S. household population. Two waves of data were collected (Wave 1: October-November 2020, n=727; Wave 2: March-May 2021, n=569). Measures included demographics, adverse childhood experiences (ACEs, 8 items), pandemic-related stress (Pandemic-Related Stress Index [PRSI], 7 items), and depression symptoms (Patient Health Questionnaire for Adolescents [PHQ-A], 9 items). Path analyses were conducted to examine pathways between Wave 1 ACEs, Wave 1 PRSI, and Wave 2 PHQ with covariates of sex and race/ethnicity. Females had higher ACEs, PRSI, and PHQ scores than males. The PRSI score at Wave 1 was positively associated with the PHQ at Wave 2 (b=0.29, SE=0.14, p<0.001). ACEs at Wave 1 were positively associated with PRSI at Wave 1 (b= 0.31, SE= 0.03, p< 0.001) andwith PHQ at Wave 2 (b=0.32, SE=0.12, p<0.001). The direct effect of ACEs on PHQ (b=0.23, SE=0.12, p<0.001) remained significant even after accounting for the indirect effect of pandemic-related stress (b=0.09, SE=0.05, p<0.001). Pandemic-related stress had a direct, adverse impact on adolescent depressive symptoms and demonstrates a compounding effect of childhood adversity and pandemic-related stress on depression. Findings can aid the design of interventions that promote mental health and support adolescent coping and recovery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40653-022-00502-0. |
Family Economics and Mental Health Among High-School Students During COVID-19.
Jones SE , Hertz MF , DeGue SA , Merlo CL , Piepenbrink RP , Le VD , Dittus PJ , Houston AL , Thornton JE , Ethier KA . Am J Prev Med 2022 64 (3) 414-422 INTRODUCTION: The COVID-19 pandemic has had unprecedented socioeconomic and health impacts in the U.S. This study examined racial/ethnic and school poverty status differences in the relationship between parent job loss, experiences with hunger, and indicators of mental health problems among public high-school students nationwide during the COVID-19 pandemic. METHODS: The study analyzed data from the Adolescent Behaviors and Experiences Survey, conducted in January-June 2021. The Adolescent Behaviors and Experiences Survey was a 1-time, cross-sectional, online survey that used a stratified, 3-stage cluster sample to obtain a nationally representative sample of high-school students in the U.S. This study was limited to public-school students (n=7,379). RESULTS: Among public high-school students nationwide, 36.9% experienced poor mental health during the pandemic, and during the past year, 43.9% experienced persistent feelings of sadness or hopelessness, 19.8% seriously considered attempting suicide, and 9.1% attempted suicide. Parent job loss and having gone hungry were associated with indicators of mental health problems overall and across racial/ethnic groups and school poverty status levels. CONCLUSIONS: Students who experience parent job loss and hunger are likely to also experience poor mental health and may be at higher risk for suicide. |
Symptoms of depression, anxiety, and post-traumatic stress disorder, and suicidal ideation among school nurses in prekindergarten through grade 12 schools - United States, March 2022
Merkle SL , Welton M , van Zyl A , Chong M , Tanner A , Rose CE , Hertz M , Hill L , Leroy ZC , Sifre K , Thomas ES . J Sch Nurs 2022 39 (2) 10598405221131048 School nurses are integral to creating safe environments in U.S. schools. Many experienced increased work burden and stress during the COVID-19 pandemic. CDC collaborated with the National Association of School Nurses and the National Association of State School Nurse Consultants to distribute a 121-item online, anonymous survey to school nurses nationwide during March 7-30, 2022. Among the 7,971 respondents, symptoms of depression, anxiety and PTSD, and suicidal ideation were measured, and prevalence ratios were used to identify associations with demographics, workplace characteristics, and support. Results found high levels of work-related stressors and indicated that employment characteristics, COVID-19-related job duties, and other workplace stressors and supports affected school nurse mental health. The survey findings underscore the mental health challenges many school nurses experienced during the 2021/2022 school year. The findings can inform supportive policies and practices to reduce workplace stressors and increase workplace supports for school nurses. |
Associations between prenatal urinary biomarkers of phthalate exposure and preterm birth: A pooled study of 16 US cohorts
Welch BM , Keil AP , Buckley JP , Calafat AM , Christenbury KE , Engel SM , O'Brien KM , Rosen EM , James-Todd T , Zota AR , Ferguson KK , Alshawabkeh AN , Cordero JF , Meeker JD , Barrett ES , Bush NR , Nguyen RHN , Sathyanarayana S , Swan SH , Cantonwine DE , McElrath TF , Aalborg J , Dabelea D , Starling AP , Hauser R , Messerlian C , Zhang Y , Bradman A , Eskenazi B , Harley KG , Holland N , Bloom MS , Newman RB , Wenzel AG , Braun JM , Lanphear BP , Yolton K , Factor-Litvak P , Herbstman JB , Rauh VA , Drobnis EZ , Sparks AE , Redmon JB , Wang C , Binder AM , Michels KB , Baird DD , Jukic AMZ , Weinberg CR , Wilcox AJ , Rich DQ , Weinberger B , Padmanabhan V , Watkins DJ , Hertz-Picciotto I , Schmidt RJ . JAMA Pediatr 2022 176 (9) 895-905 IMPORTANCE: Phthalate exposure is widespread among pregnant women and may be a risk factor for preterm birth. OBJECTIVE: To investigate the prospective association between urinary biomarkers of phthalates in pregnancy and preterm birth among individuals living in the US. DESIGN, SETTING, AND PARTICIPANTS: Individual-level data were pooled from 16 preconception and pregnancy studies conducted in the US. Pregnant individuals who delivered between 1983 and 2018 and provided 1 or more urine samples during pregnancy were included. EXPOSURES: Urinary phthalate metabolites were quantified as biomarkers of phthalate exposure. Concentrations of 11 phthalate metabolites were standardized for urine dilution and mean repeated measurements across pregnancy were calculated. MAIN OUTCOMES AND MEASURES: Logistic regression models were used to examine the association between each phthalate metabolite with the odds of preterm birth, defined as less than 37 weeks of gestation at delivery (n=539). Models pooled data using fixed effects and adjusted for maternal age, race and ethnicity, education, and prepregnancy body mass index. The association between the overall mixture of phthalate metabolites and preterm birth was also examined with logistic regression. G-computation, which requires certain assumptions to be considered causal, was used to estimate the association with hypothetical interventions to reduce the mixture concentrations on preterm birth. RESULTS: The final analytic sample included 6045 participants (mean [SD] age, 29.1 [6.1] years). Overall, 802 individuals (13.3%) were Black, 2323 (38.4%) were Hispanic/Latina, 2576 (42.6%) were White, and 328 (5.4%) had other race and ethnicity (including American Indian/Alaskan Native, Native Hawaiian, >1 racial identity, or reported as other). Most phthalate metabolites were detected in more than 96% of participants. Higher odds of preterm birth, ranging from 12% to 16%, were observed in association with an interquartile range increase in urinary concentrations of mono-n-butyl phthalate (odds ratio [OR], 1.12 [95% CI, 0.98-1.27]), mono-isobutyl phthalate (OR, 1.16 [95% CI, 1.00-1.34]), mono(2-ethyl-5-carboxypentyl) phthalate (OR, 1.16 [95% CI, 1.00-1.34]), and mono(3-carboxypropyl) phthalate (OR, 1.14 [95% CI, 1.01-1.29]). Among approximately 90 preterm births per 1000 live births in this study population, hypothetical interventions to reduce the mixture of phthalate metabolite levels by 10%, 30%, and 50% were estimated to prevent 1.8 (95% CI, 0.5-3.1), 5.9 (95% CI, 1.7-9.9), and 11.1 (95% CI, 3.6-18.3) preterm births, respectively. CONCLUSIONS AND RELEVANCE: Results from this large US study population suggest that phthalate exposure during pregnancy may be a preventable risk factor for preterm delivery. |
Student and School Characteristics Associated With COVID-19-Related Learning Decline Among Middle and High School Students in K-12 Schools.
Fisher HH , Hawkins GT , Hertz M , Sliwa S , Beresovsky V . J Sch Health 2022 92 (11) 1027-1039 BACKGROUND: COVID-19-disrupted schools, including shifts to virtual learning which may have impacted academic progress. This study assessed characteristics associated with changes in academic grades (before and during the pandemic) for different learning modalities for US students ages 13-19. METHODS: Students (N = 2152) completed a web survey on school-related experiences during the 2020-2021 school year. County social vulnerability and SARS-CoV-2 transmission data were merged with survey data. Multivariable logistic regression analysis for grade change was conducted with student and school characteristics for each learning modality, controlling for community characteristics. RESULTS: Greater proportions of remote/virtual (34.4%) and hybrid (30.1%) learning students reported grade decline compared to in-person students (19.9%). Among in-person students, odds of reporting same/improved grades were 65% lower among non-Hispanic black students and 66% lower among non-Hispanic students from other races, compared to non-Hispanic white students. Among hybrid students, odds of reporting same/improved grades for students reporting anxiety were 47% lower than students without anxiety, and odds of reporting same/improved grades among students reporting substance use were 40% lower than students not reporting substance use. Among remote/virtual students, odds of reporting same/improved grades among students with depression were 62% lower than odds of students not reporting depression symptoms. Remote/virtual students who received school-provided educational services also had 1.55 times the odds of reporting same/improved grades, compared to remote/virtual students not receiving these services. CONCLUSIONS: Academic grades were negatively impacted during COVID-19 and learning mode may have contributed. Understanding these impacts is critical to student health and academic achievement. |
Longitudinal changes in maternal serum concentrations of per- and polyfluoroalkyl substances from pregnancy to two years postpartum
Oh J , Bennett DH , Tancredi DJ , Calafat AM , Schmidt RJ , Hertz-Picciotto I , Shin HM . Environ Sci Technol 2022 56 (16) 11449-11459 Exposure to per- and polyfluoroalkyl substances (PFAS) during pregnancy and lactation is of increasing public health concern, but little is known about longitudinal changes in maternal PFAS concentrations from pregnancy to a few years postpartum. We quantified 11 PFAS in 251 serum samples prospectively collected from 42 Northern California mothers during the first, second, and third trimesters of pregnancy and at 3, 6, and 24 months after delivery over 2009-2017. We fit separate linear mixed models during pregnancy, early postpartum, and late postpartum to estimate percent changes of PFAS for each subperiod. Among five PFAS detected in more than 99% of samples, linear and branched perfluorooctanesulfonate (n- and Sm-PFOS), linear perfluorooctanoate (n-PFOA), and perfluorononanoate (PFNA) concentrations changed -4% to -3% per month during pregnancy. During early postpartum, perfluorohexanesulfonate (PFHxS) and n-PFOA concentrations changed -6% and -5%, respectively, per month, and Sm-PFOS and PFNA concentrations changed -1% per month. During late postpartum, n-PFOS, Sm-PFOS, and PFNA concentrations changed -1% per month. Breastfeeding duration was the primary determinant of n-PFOA and PFNA concentrations during late postpartum, showing negative associations. Our findings might be useful for reconstructing reliable prenatal or early life PFAS exposures for offspring. |
The relationship of school connectedness to adolescents' engagement in co-occurring health risks: A meta-analytic review
Rose ID , Lesesne CA , Sun J , Johns MM , Zhang X , Hertz M . J Sch Nurs 2022 40 (1) 10598405221096802 School connectedness is an important factor in the lives of youth and are a leverage point for optimizing youth's social, emotional, and physical health. This study presents a meta-analysis examining the relationship between school connectedness and four health domains that are prevalent in adolescence, have implications for adult health, and often co-occur: mental health, sexual health, violence, and high-risk substance use. Ninety articles published between 2009 and 2019 were included in the analysis. The study found that school connectedness had a protective average effect size across all health domains (Hedges' g = -0.345, p-value<0.001). When examined separately, school connectedness had a significant protective relationship with substance use (g = -0.379, p < 0.001), mental health (Hedges' g = -0.358, p < 0.001), violence (Hedges' g = -0.318, p < 0.001), sexual health (Hedges' g = -0.145, p < 0.001), and with co-occurring risks (Hedges' g = -0.331, p < 0.001). These results provide strong evidence that school connectedness has the potential to prevent and mitigate multiple health risks during adolescence. |
Defining the risk of SARS-CoV-2 variants on immune protection.
DeGrace MM , Ghedin E , Frieman MB , Krammer F , Grifoni A , Alisoltani A , Alter G , Amara RR , Baric RS , Barouch DH , Bloom JD , Bloyet LM , Bonenfant G , Boon ACM , Boritz EA , Bratt DL , Bricker TL , Brown L , Buchser WJ , Carreo JM , Cohen-Lavi L , Darling TL , Davis-Gardner ME , Dearlove BL , Di H , Dittmann M , Doria-Rose NA , Douek DC , Drosten C , Edara VV , Ellebedy A , Fabrizio TP , Ferrari G , Florence WC , Fouchier RAM , Franks J , Garca-Sastre A , Godzik A , Gonzalez-Reiche AS , Gordon A , Haagmans BL , Halfmann PJ , Ho DD , Holbrook MR , Huang Y , James SL , Jaroszewski L , Jeevan T , Johnson RM , Jones TC , Joshi A , Kawaoka Y , Kercher L , Koopmans MPG , Korber B , Koren E , Koup RA , LeGresley EB , Lemieux JE , Liebeskind MJ , Liu Z , Livingston B , Logue JP , Luo Y , McDermott AB , McElrath MJ , Meliopoulos VA , Menachery VD , Montefiori DC , Mhlemann B , Munster VJ , Munt JE , Nair MS , Netzl A , Niewiadomska AM , O'Dell S , Pekosz A , Perlman S , Pontelli MC , Rockx B , Rolland M , Rothlauf PW , Sacharen S , Scheuermann RH , Schmidt SD , Schotsaert M , Schultz-Cherry S , Seder RA , Sedova M , Sette A , Shabman RS , Shen X , Shi PY , Shukla M , Simon V , Stumpf S , Sullivan NJ , Thackray LB , Theiler J , Thomas PG , Trifkovic S , Treli S , Turner SA , Vakaki MA , vanBakel H , VanBlargan LA , Vincent LR , Wallace ZS , Wang L , Wang M , Wang P , Wang W , Weaver SC , Webby RJ , Weiss CD , Wentworth DE , Weston SM , Whelan SPJ , Whitener BM , Wilks SH , Xie X , Ying B , Yoon H , Zhou B , Hertz T , Smith DJ , Diamond MS , Post DJ , Suthar MS . Nature 2022 605 (7911) 640-652 The global emergence of many severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants jeopardizes the protective antiviral immunity induced following infection or vaccination. To address the public health threat caused by the increasing SARS-CoV-2 genomic diversity, the National Institute of Allergy and Infectious Diseases (NIAID) within the National Institutes of Health (NIH) established the SARS-CoV-2 Assessment of Viral Evolution (SAVE) program. This effort was designed to provide a real-time risk assessment of SARS-CoV-2 variants potentially impacting transmission, virulence, and resistance to convalescent and vaccine-induced immunity. The SAVE program serves as a critical data-generating component of the United States Government SARS-CoV-2 Interagency Group to assess implications of SARS-CoV-2 variants on diagnostics, vaccines, and therapeutics and for communicating public health risk. Here we describe the coordinated approach used to identify and curate data about emerging variants, their impact on immunity, and effects on vaccine protection using animal models. We report the development of reagents, methodologies, models, and pivotal findings facilitated by this collaborative approach and identify future challenges. This program serves as a template for the response against rapidly evolving pandemic pathogens by monitoring viral evolution in the human population to identify variants that could erode the effectiveness of countermeasures. |
Incidence Estimates of Acute Q Fever and Spotted Fever Group Rickettsioses, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014
Pisharody S , Rubach MP , Carugati M , Nicholson WL , Perniciaro JL , Biggs HM , Maze MJ , Hertz JT , Halliday JEB , Allan KJ , Mmbaga BT , Saganda W , Lwezaula BF , Kazwala RR , Cleaveland S , Maro VP , Crump JA . Am J Trop Med Hyg 2021 106 (2) 494-503 Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in northern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance-coupling case-finding at two referral hospitals and healthcare utilization data-we estimated the incidences of acute Q fever and SFGR in Moshi, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014. Cases were defined as fever and a four-fold or greater increase in antibody titers of acute and convalescent paired sera according to the indirect immunofluorescence assay of Coxiella burnetii phase II antigen for acute Q fever and Rickettsia conorii (2007-2008) or Rickettsia africae (2012-2014) antigens for SFGR. Healthcare utilization data were used to adjust for underascertainment of cases by sentinel surveillance. For 2007 to 2008, among 589 febrile participants, 16 (4.7%) of 344 and 27 (8.8%) of 307 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 80 (uncertainty range, 20-454) and 147 (uncertainty range, 52-645) per 100,000 persons, respectively. For 2012 to 2014, among 1,114 febrile participants, 52 (8.1%) and 57 (8.9%) of 641 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 56 (uncertainty range, 24-163) and 75 (uncertainty range, 34-176) per 100,000 persons, respectively. We found substantial incidences of acute Q fever and SFGR in northern Tanzania during both study periods. To our knowledge, these are the first incidence estimates of either disease in sub-Saharan Africa. Our findings suggest that control measures for these infections warrant consideration. |
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