Last data update: Nov 11, 2024. (Total: 48109 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Krishnasamy VP[original query] |
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Leveraging Rapid Response Activities to Build Public Health Capacity: Development of the Opioid Rapid Response Team Model
Gaertner SJ , Krishnasamy VP , Simone PM , Schuchat A . Health Secur 2022 20 (1) 87-91 As part of the federal response to the opioid crisis, the Opioid Rapid Response Team project (2018-2019) was created to provide rapid short-term assistance to requesting US jurisdictions responding to an acute opioid-related event. The project used an approach that maximized overall value by leveraging existing federal resources and harnessing opportunities to meet project-specific objectives while also enhancing general response capacity at the federal, state, and local levels. This tandem capacity building for both opioid rapid response and general response focused on systems and operations, workforce readiness, technical assistance, and partnerships. In this article, we demonstrate the ancillary value that issue-specific response activities can contribute to broader public health response capacity. |
Characteristics of persons who report using only nicotine-containing products among interviewed patients with e-cigarette, or vaping, product use-associated lung injury - Illinois, August-December 2019
Ghinai I , Navon L , Gunn JKL , Duca LM , Brister S , Love S , Brink R , Fajardo G , Johnson J , Saathoff-Huber L , King BA , Jones CM , Krishnasamy VP , Layden JE . MMWR Morb Mortal Wkly Rep 2020 69 (3) 84-89 In 2019, the United States experienced an outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). Most EVALI patients have reported using tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, products obtained from informal sources (2,3), and vitamin E acetate in these products has been closely linked with EVALI (4,5). However, some EVALI patients report using only nicotine-containing products. This study compared demographic, product use, and clinical characteristics of EVALI patients in Illinois who reported using only nicotine-containing e-cigarette, or vaping, products with those of patients who reported using any THC-containing products. Among 121 interviewed Illinois EVALI patients, 17 (14%) reported using only nicotine-containing products, including nine (7%) patients who had no indication of any THC use, based on self-report or toxicology testing. Compared with patients who used any THC-containing products, these nine patients were significantly more likely to be older and female and were less likely to experience constitutional symptoms or to have leukocytosis on initial evaluation. Although vitamin E acetate has been strongly linked with EVALI, evidence is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC- or non-THC-containing products, in some reported EVALI cases. The contributing cause or causes of EVALI for patients reporting use of only nicotine-containing products warrants further investigation. |
Update: Characteristics of a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury - United States, August 2019-January 2020
Krishnasamy VP , Hallowell BD , Ko JY , Board A , Hartnett KP , Salvatore PP , Danielson M , Kite-Powell A , Twentyman E , Kim L , Cyrus A , Wallace M , Melstrom P , Haag B , King BA , Briss P , Jones CM , Pollack LA , Ellington S . MMWR Morb Mortal Wkly Rep 2020 69 (3) 90-94 Since August 2019, CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders have been investigating a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). This report updates patient demographic characteristics, self-reported substance use, and hospitalization dates for EVALI patients reported to CDC by states, as well as the distribution of emergency department (ED) visits related to e-cigarette, or vaping, products analyzed through the National Syndromic Surveillance Program (NSSP). As of January 14, 2020, a total of 2,668 hospitalized EVALI cases had been reported to CDC. Median patient age was 24 years, and 66% were male. Overall, 82% of EVALI patients reported using any tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, product (including 33% with exclusive THC-containing product use), and 57% of EVALI patients reported using any nicotine-containing product (including 14% with exclusive nicotine-containing product use). Syndromic surveillance indicates that ED visits related to e-cigarette, or vaping, products continue to decline after sharply increasing in August 2019 and peaking in September 2019. Clinicians and public health practitioners should remain vigilant for new EVALI cases. CDC recommends that persons not use THC-containing e-cigarette, or vaping, products, especially those acquired from informal sources such as friends, family members, or from in-person or online dealers. Vitamin E acetate is strongly linked to the EVALI outbreak and should not be added to any e-cigarette, or vaping, products (2). However, evidence is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC- or non-THC-containing products, in some reported EVALI cases. |
Outbreak characteristics and epidemic curves for multistate outbreaks of Salmonella infections associated with produce: United States, 2009-2015
Krishnasamy VP , Marshall K , Dewey-Mattia D , Wise M . Foodborne Pathog Dis 2019 17 (1) 15-22 Produce is recognized as a source of Salmonella-related foodborne outbreaks in the United States. Identifying produce as a source of foodborne outbreaks is challenging given short product shelf lives and durations of many produce-associated outbreaks. Investigators consider produce a plausible source when illnesses occur over a short time period and disproportionately affect middle-aged or female individuals. We reviewed characteristics of past Salmonella produce outbreaks and their consistency with principles used by epidemiologists when generating hypotheses about an outbreak source. We queried the Foodborne Disease Outbreak Surveillance System for multistate, produce-associated Salmonella outbreaks reported to the Centers for Disease Control and Prevention from 2009 to 2015. All produce-associated outbreaks were classified as fruit outbreaks or vegetable outbreaks using an established classification scheme. We then compared fruit and vegetable outbreaks by characteristics of size, gender, age, age groups, geographic spread, duration, and velocity measures using Wilcoxon rank-sum tests. Epidemic curves were created to display visual representations of outbreak duration and velocity. We identified 14 fruit outbreaks and 24 vegetable outbreaks. The median number of illnesses for all produce-associated outbreaks was 30 and a high median percentage of illnesses were in females (61.9%). Median age was 34 years, with a median of 53.2% of illnesses affecting the 18-59 age group. For all outbreaks, median duration was 77 d and median time to the 50th percentile of illnesses was 32.5 d. Fruit and vegetable outbreaks differed only in the age groups affected. We used outbreak data to verify common indicators of produce-associated Salmonella outbreaks. Outbreaks affected females and middle-aged individuals more commonly, while fruit and vegetable outbreaks impacted different age groups. Although median outbreak duration was less than 12 weeks for both fruit and vegetable outbreaks, there was considerable variation, decreasing its utility as an indicator of produce as a source of the outbreak. |
Severe pulmonary disease associated with electronic-cigarette-product use - interim guidance
Schier JG , Meiman JG , Layden J , Mikosz CA , VanFrank B , King BA , Salvatore PP , Weissman DN , Thomas J , Melstrom PC , Baldwin GT , Parker EM , Courtney-Long EA , Krishnasamy VP , Pickens CM , Evans ME , Tsay SV , Powell KM , Kiernan EA , Marynak KL , Adjemian J , Holton K , Armour BS , England LJ , Briss PA , Houry D , Hacker KA , Reagan-Steiner S , Zaki S , Meaney-Delman D . MMWR Morb Mortal Wkly Rep 2019 68 (36) 787-790 On September 6, 2019, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). As of August 27, 2019, 215 possible cases of severe pulmonary disease associated with the use of electronic cigarette (e-cigarette) products (e.g., devices, liquids, refill pods, and cartridges) had been reported to CDC by 25 state health departments. E-cigarettes are devices that produce an aerosol by heating a liquid containing various chemicals, including nicotine, flavorings, and other additives (e.g., propellants, solvents, and oils). Users inhale the aerosol, including any additives, into their lungs. Aerosols produced by e-cigarettes can contain harmful or potentially harmful substances, including heavy metals such as lead, volatile organic compounds, ultrafine particles, cancer-causing chemicals, or other agents such as chemicals used for cleaning the device (1). E-cigarettes also can be used to deliver tetrahydrocannabinol (THC), the principal psychoactive component of cannabis, or other drugs; for example, "dabbing" involves superheating substances that contain high concentrations of THC and other plant compounds (e.g., cannabidiol) with the intent of inhaling the aerosol. E-cigarette users could potentially add other substances to the devices. This report summarizes available information and provides interim case definitions and guidance for reporting possible cases of severe pulmonary disease. The guidance in this report reflects data available as of September 6, 2019; guidance will be updated as additional information becomes available. |
Public health investigation and response to a hepatitis A outbreak from imported scallops consumed raw - Hawaii, 2016
Viray MA , Hofmeister MG , Johnston DI , Krishnasamy VP , Nichols C , Foster MA , Balajadia R , Wise ME , Manuzak A , Lin Y , Xia G , Basler C , Nsubuga J , Woods J , Park SY . Epidemiol Infect 2018 147 1-8 During the summer of 2016, the Hawaii Department of Health responded to the second-largest domestic foodborne hepatitis A virus (HAV) outbreak in the post-vaccine era. The epidemiological investigation included case finding and investigation, sequencing of RNA positive clinical specimens, product trace-back and virologic testing and sequencing of HAV RNA from the product. Additionally, an online survey open to all Hawaii residents was conducted to estimate baseline commercial food consumption. We identified 292 confirmed HAV cases, of whom 11 (4%) were possible secondary cases. Seventy-four (25%) were hospitalised and there were two deaths. Among all cases, 94% reported eating at Oahu or Kauai Island branches of Restaurant Chain A, with 86% of those cases reporting raw scallop consumption. In contrast, a food consumption survey conducted during the outbreak indicated 25% of Oahu residents patronised Restaurant Chain A in the 7 weeks before the survey. Product trace-back revealed a single distributor that supplied scallops imported from the Philippines to Restaurant Chain A. Recovery, amplification and sequence comparison of HAV recovered from scallops revealed viral sequences matching those from case-patients. Removal of product from implicated restaurants and vaccination of those potentially exposed led to the cessation of the outbreak. This outbreak further highlights the need for improved imported food safety. |
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