Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Johnson MG [original query] |
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Familial Creutzfeldt-Jakob Disease Cluster Among an African American Family.
Johnson MG , Bradley KK , Coffman RL , Belay ED . J Public Health Manag Pract 2016 23 (6) 614-617 Familial Creutzfeldt-Jakob disease (fCJD) results from inheritance of mutations in the prion protein gene. Confirming fCJD diagnosis is essential for informing persons of their potential hereditary risk and for genetic counseling to support personal decisions for genetic testing and family planning. We describe a case of fCJD that was linked to a large cluster of African Americans with fCJD identified through a public health investigation, including 8 confirmed cases and 13 suspected cases involving 7 generations in 1 family. Genetic counseling is an important component of fCJD management for families coping with genetic prion diseases. |
Identifying heat-related deaths by using medical examiner and vital statistics data: Surveillance analysis and descriptive epidemiology - Oklahoma, 1990-2011
Johnson MG , Brown S , Archer P , Wendelboe A , Magzamen S , Bradley KK . Environ Res 2016 150 30-37 OBJECTIVES: Approximately 660 deaths occur annually in the United States associated with excess natural heat. A record heat wave in Oklahoma during 2011 generated increased interest concerning heat-related mortality among public health preparedness partners. We aimed to improve surveillance for heat-related mortality and better characterize heat-related deaths in Oklahoma during 1990-2011, and to enhance public health messaging during future heat emergencies. METHODS: Heat-related deaths were identified by querying vital statistics (VS) and medical examiner (ME) data during 1990-2011. Case inclusion criteria were developed by using heat-related International Classification of Diseases codes, cause-of-death nomenclature, and ME investigation narrative. We calculated sensitivity and predictive value positive (PVP) for heat-related mortality surveillance by using VS and ME data and performed a descriptive analysis. RESULTS: During the study period, 364 confirmed and probable heat-related deaths were identified when utilizing both data sets. ME reports had 87% sensitivity and 74% PVP; VS reports had 80% sensitivity and 52% PVP. Compared to Oklahoma's general population, decedents were disproportionately male (67% vs. 49%), aged ≥65 years (46% vs. 14%), and unmarried (78% vs. 47%). Higher rates of heat-related mortality were observed among Blacks. Of 95 decedents with available information, 91 (96%) did not use air conditioning. CONCLUSIONS: Linking ME and VS data sources together and using narrative description for case classification allows for improved case ascertainment and surveillance data quality. Males, Blacks, persons aged ≥65 years, unmarried persons, and those without air conditioning carry a disproportionate burden of the heat-related deaths in Oklahoma. |
Medium matters: modeling the impact of solid medium performance on tuberculosis trial sample size requirements
Johnson MG , Stout JE , Benator DA , Whitworth WC , Holland DP . Int J Tuberc Lung Dis 2016 20 (5) 600-4 SETTING: Two-month solid medium culture conversion is a commonly used, if suboptimal, endpoint for phase 2 anti-tuberculosis treatment trials. OBJECTIVE AND DESIGN: To model the effect of the performance characteristics (sensitivity and contamination rate) of solid medium on required sample size for a two-arm clinical trial with 85% true (gold standard) culture conversion in the control and 95% in the experimental arm. RESULTS: Increasing sensitivity and decreasing contamination reduced the sample size from 239 subjects/arm (60% sensitivity, 30% contamination) to 138 subjects/arm (95% sensitivity, 1% contamination). CONCLUSION: Optimizing solid medium has significant potential to reduce sample size and increase the efficiency of tuberculosis clinical trials. |
Seasonality and survival associated with three outbreak seasons of West Nile virus disease in Oklahoma - 2003, 2007, and 2012
Johnson MG , Adams J , McDonald-Hamm C , Wendelboe A , Bradley KK . J Med Virol 2015 87 (10) 1633-40 West Nile virus (WNV) activity has fluctuated in the south-central United States since its introduction. Seasonal outbreaks are common, with three in Oklahoma during 2003, 2007, and 2012. Morbidity and mortality rates vary during each outbreak. Long-term neurologic sequelae in association with West Nile virus disease (WNVD) are well-described, but limited information is available about delayed mortality among acute WNV infection survivors. A retrospective cohort analysis of all confirmed and probable WNVD cases reported to the Oklahoma State Department of Health (OSDH) during 2003, 2007, and 2012 was performed. OSDH surveillance data and mortality data from Oklahoma's vital statistics database were used to construct a descriptive epidemiologic analysis of the geography, temporality, severity, and associated mortality for each outbreak season. A Kaplan-Meier survival curve and standardized mortality ratios (SMRs) were calculated to measure survival of the 2003 and 2007 WNVD cohorts. Seventy-nine cases during 2003, 107 cases during 2007, and 180 cases during 2012 met inclusion criteria. Median ages of the 2003, 2007, and 2012 cohorts were 48, 58, and 59 years, respectively; race, sex, and symptom information were not substantially different. Each outbreak season had a different severity, temporality, and geography. Age- and sex-adjusted SMRs for the combined 2003 and 2007 cohorts censored at 5 years was 0.9 (95% confidence interval 0.51-1.75); no substantial difference was observed between the survival curves. Although similar patterns of long-term mortality were evident on the survival curves, SMRs did not demonstrate increased 5-year cumulative risk for death for patients surviving acute WNV infection. |
Completeness and timeliness of electronic vs. conventional laboratory reporting for communicable disease surveillance - Oklahoma, 2011
Johnson MG , Williams J , Lee A , Bradley KK . Public Health Rep 2014 129 (3) 261-266 OBJECTIVES: The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages the meaningful use of certified electronic health record technology. A HITECH-compliant core component is nationwide electronic laboratory reporting (ELR) implementation for communicable disease surveillance. In Oklahoma, laboratories with ≥400 positive tests/year for reportable diseases must use ELR. Of 18 such laboratories, two have adopted ELR. We compared completeness and timeliness of ELR reports from these two laboratories with conventional reports from all other Oklahoma laboratories. METHODS: We retrospectively reviewed confirmed reportable disease cases for January 1-December 31, 2011, excluding tuberculosis, hepatitis, sexually transmitted infections, diseases without laboratory diagnoses, and immediately reportable diseases. Probable reportable tickborne disease cases were included. We compared ELR with conventional reporting (i.e., mail, fax, telephone, and Internet). We assessed data completeness based on eight demographic and two laboratory fields in each disease report and timeliness by percentage of cases reported in ≤1 business day. RESULTS: Overall, 1,867 reports met the inclusion criteria; 24% of these reports had been submitted by ELR. Data completeness was 90% for ELR and 95% for conventional reporting. Patient addresses accounted for 97% of the missing data fields for ELR reports. Timeliness was 91% for ELR and 87% for conventional reports. CONCLUSIONS: Although early in the transition to ELR compliance in Oklahoma, ELR has already yielded improved timeliness for communicable disease surveillance. However, ELR did not yield more complete reports than conventional reporting. Requiring specific demographic data fields for ELR reports can improve the completeness of ELR. |
Vaccine-preventable disease among homeschooled children: two cases of tetanus in Oklahoma
Johnson MG , Bradley KK , Mendus S , Burnsed L , Clinton R , Tiwari T . Pediatrics 2013 132 (6) e1686-9 Homeschooled children represent an increasing proportion of school-aged children in the United States. Immunization rates among homeschooled children are largely unknown because they are usually not subject to state-based school-entry vaccination requirements. Geographic foci of underimmunized children can increase the risk for outbreaks of vaccine-preventable diseases. In 2012, 2 cases of tetanus were reported in Oklahoma; both cases involved homeschooled children without documentation of diphtheria-tetanus-acellular pertussis vaccination. We describe the characteristics of both patients and outline innovative outreach measures with the potential to increase vaccination access and coverage among homeschooled children. |
Recognizing Laboratory Cross-Contamination: Two False-Positive Cultures of Mycobacterium tuberculosis-Oklahoma, 2011
Johnson MG , Lindsey PH , Harvey CF , Bradley KK . Chest 2013 144 (1) 319-22 Mycobacterium tuberculosis (MTB) isolation from clinical specimens is the standard for TB diagnosis. Positive MTB cultures are rarely questioned, but false-positive culture rates range from 2% to 4%. In December 2011, two smear-negative, culture-positive TB cases were reported to the Oklahoma State Department of Health (OSDH) in people without TB signs or symptoms. OSDH TB control officers interviewed physicians and laboratory personnel, reviewed patient charts, traced epidemiologic links, and performed microbiologic studies to determine if these were true TB cases. Both specimens were found to have been processed on the same day, at the same laboratory, under the same hood, and by the same technician sequentially after a strongly smear-positive TB specimen. No epidemiologic links were identified among the three patients. Spoligotyping and 24-locus mycobacterial interspersed repetitive unit typing of the three specimens were identical. Only liquid media grew MTB in the two questionable specimens. A laboratory splash incident was suspected, whereby all three liquid media sample lids were open during inoculation rather than being opened one at a time, causing cross-contamination. Also, the two specimens were incubated for 2-3 weeks longer than standard protocol before MTB growth was observed. Patient 1 was not treated for TB because her physician doubted the culture result. Patient 2, an organ transplant recipient, began four-drug anti-TB therapy, and an investigation was initiated for transplant-associated TB. Adherence to strict laboratory techniques and recognizing the possibility of false-positive MTB cultures, especially when inconsistent with clinical data, are essential in preventing erroneous TB diagnoses. |
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