Last data update: Oct 28, 2024. (Total: 48004 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Lo YC[original query] |
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Epidemiological characteristics and associated factors of acute hepatitis A outbreak among HIV-coinfected men who have sex with men in Taiwan, June 2015-December 2016
Cheng CY , Wu HH , Zou H , Lo YC . J Viral Hepat 2018 25 (10) 1208-1215 In Taiwan, an outbreak of acute hepatitis A (AHA) infection has been identified since June 2015. Approximately half of the cases occurred in HIV-infected men who have sex with men (MSM). We used the Taiwan Centers for Disease Control (TCDC)-operated National Disease Surveillance Systems (NDSS) to identify the incidence of AHA during 2011-2016. Between June 2015 and December 2016, a total of 1,268 AHA cases were documented, and 601 cases (47.4%) were co-infected with HIV; the majority of whom were MSM (98.4%). Each AHA case was matched to two HIV-infected controls without AHA reported in the NDSS on age (+/- 5 years), risk factor of HIV infection, HIV diagnosis date (+/- 30 days) and county/city of residence at HIV diagnosis. Three hundred forty-three HIV/AHA cases were matched to 686 controls. In multivariable conditional logistic regression analysis, a previous gonorrhea (adjusted OR=1.77, 95% CI 1.16-2.70), and recent (aOR=6.77, 95% CI 4.34-10.55) or remote syphilis report (aOR=3.56, 95% CI 2.48-5.13) were independently associated with AHA. The epidemic persisted till December 2016, and the cases with a new diagnosis of HIV infection after AHA (28/301, 9.3%) increased after July 2016 (p=0.001). HIV/AHA cases were centralized in northern and central metropolitan areas and HIV-infected MSM with a recent history of sexually transmitted diseases in Taiwan. We recommend surveillance of associated behavioral and virologic characteristics and HAV counseling and testing for HIV-infected men. This article is protected by copyright. All rights reserved. |
Increased respiratory disease mortality at a microwave popcorn production facility with worker risk of bronchiolitis obliterans
Halldin CN , Suarthana E , Fedan KB , Lo YC , Turabelidze G , Kreiss K . PLoS One 2013 8 (2) e57935 BACKGROUND: Bronchiolitis obliterans, an irreversible lung disease, was first associated with inhalation of butter flavorings (diacetyl) in workers at a microwave popcorn company. Excess rates of lung-function abnormalities were related to cumulative diacetyl exposure. Because information on potential excess mortality would support development of permissible exposure limits for diacetyl, we investigated respiratory-associated mortality during 2000-2011 among current and former workers at this company who had exposure to flavorings and participated in cross-sectional surveys conducted between 2000-2003. METHODS: We ascertained workers' vital status through a Social Security Administration search. Causes of death were abstracted from death certificates. Because bronchiolitis obliterans is not coded in the International Classification of Disease 10 revision (ICD-10), we identified respiratory mortality decedents with ICD-10 codes J40-J44 which encompass bronchitis (J40), simple and mucopurulent chronic bronchitis (J41), unspecified chronic bronchitis (J42), emphysema (J43), and other chronic obstructive pulmonary disease (COPD) (J44). We calculated expected number of deaths and standardized mortality ratios (SMRs) with 95% confidence intervals (CI) to determine if workers exposed to diacetyl experienced greater respiratory mortality than expected. RESULTS: We identified 15 deaths among 511 workers. Based on U.S. population estimates, 17.39 deaths were expected among these workers (SMR = 0.86; CI:0.48-1.42). Causes of death were available for 14 decedents. Four deaths among production and flavor mixing workers were documented to have a multiple cause of 'other COPD' (J44), while 0.98 'other COPD'-associated deaths were expected (SMR = 4.10; CI:1.12-10.49). Three of the 4 'other COPD'-associated deaths occurred among former workers and workers employed before the company implemented interventions reducing diacetyl exposure in 2001. CONCLUSION: Workers at the microwave popcorn company experienced normal rates of all-cause mortality but higher rates of COPD-associated mortality, especially workers employed before the company reduced diacetyl exposure. The demonstrated excess in COPD-associated mortality suggests continued efforts to lower flavoring exposure are prudent. |
Necrotizing cutaneous mucormycosis after a tornado in Joplin, Missouri, in 2011
Fanfair RN , Benedict K , Bos J , Bennett SD , Lo YC , Adebanjo T , Etienne K , Deak E , Derado G , Shieh WJ , Drew C , Zaki S , Sugerman D , Gade L , Thompson EH , Sutton DA , Engelthaler DM , Schupp JM , Brandt ME , Harris JR , Lockhart SR , Turabelidze G , Park BJ . N Engl J Med 2012 367 (23) 2214-25 BACKGROUND: Mucormycosis is a fungal infection caused by environmentally acquired molds. We investigated a cluster of cases of cutaneous mucormycosis among persons injured during the May 22, 2011, tornado in Joplin, Missouri. METHODS: We defined a case as a soft-tissue infection in a person injured during the tornado, with evidence of a mucormycete on culture or immunohistochemical testing plus DNA sequencing. We conducted a case-control study by reviewing medical records and conducting interviews with case patients and hospitalized controls. DNA sequencing and whole-genome sequencing were performed on clinical specimens to identify species and assess strain-level differences, respectively. RESULTS: A total of 13 case patients were identified, 5 of whom (38%) died. The patients had a median of 5 wounds (range, 1 to 7); 11 patients (85%) had at least one fracture, 9 (69%) had blunt trauma, and 5 (38%) had penetrating trauma. All case patients had been located in the zone that sustained the most severe damage during the tornado. On multivariate analysis, infection was associated with penetrating trauma (adjusted odds ratio for case patients vs. controls, 8.8; 95% confidence interval [CI], 1.1 to 69.2) and an increased number of wounds (adjusted odds ratio, 2.0 for each additional wound; 95% CI, 1.2 to 3.2). Sequencing of the D1-D2 region of the 28S ribosomal DNA yielded Apophysomyces trapeziformis in all 13 case patients. Whole-genome sequencing showed that the apophysomyces isolates were four separate strains. CONCLUSIONS: We report a cluster of cases of cutaneous mucormycosis among Joplin tornado survivors that were associated with substantial morbidity and mortality. Increased awareness of fungi as a cause of necrotizing soft-tissue infections after a natural disaster is warranted. |
Childhood lead poisoning associated with gold ore processing: a village-level investigation - Zamfara State, Nigeria, October-November 2010
Lo YC , Dooyema CA , Neri A , Durant J , Jefferies T , Medina-Marino A , de Ravello L , Thoroughman D , Davis L , Dankoli RS , Samson MY , Ibrahim LM , Okechukwu O , Umar-Tsafe NT , Dama AH , Brown MJ . Environ Health Perspect 2012 120 (10) 1450-5 BACKGROUND: During May-June 2010, a childhood lead poisoning outbreak related to gold-ore-processing was confirmed in 2 villages in Zamfara State, Nigeria. During June-September, villages with suspected or confirmed childhood lead poisoning continued to be identified in Zamfara State. OBJECTIVES: We investigated the extent of childhood lead poisoning (≥1 child with a blood lead level [BLL] ≥10 microg/dL) and lead contamination (≥1 soil/dust sample with a lead level >400 parts per million) among villages in Zamfara State and identified villages that should be prioritized for urgent interventions. METHODS: We used chain-referral sampling to identify villages of interest, defined as villages suspected of participation in gold-ore-processing during the previous 12 months. We interviewed villagers, determined BLLs among children aged <5 years, and analyzed soil/dust from public areas and homes for lead. RESULTS: We identified 131 villages of interest and visited 74 (56%) villages in 3 local government areas. Fifty-four (77%) of 70 villages that completed the survey reported gold-ore-processing. Ore-processing villages were more likely to have ≥1 child aged <5 years with lead poisoning (68% vs. 50%, p=0.17) or death following convulsions (74% vs. 44%, p=0.02). Soil/dust contamination and BLL ≥45 microg/dL were identified in ore-processing villages only [50% (p<0.001) and 15% (p=0.22), respectively]. The odds of childhood lead poisoning or lead contamination was 3.5 times as high in ore-processing villages than the other villages (95% CI: 1.1, 11.3). CONCLUSION: Childhood lead poisoning and lead contamination were widespread in surveyed areas, particularly among villages that had processed ore recently. Urgent interventions are required to reduce lead exposure, morbidity, and mortality in affected communities. |
Prevalence and determinants of recent HIV testing among sexually active men who have sex with men in the St. Louis metropolitan area, Missouri, 2008
Lo YC , Turabelidze G , Lin M , Friedberg Y . Sex Transm Dis 2012 39 (4) 306-11 BACKGROUND: New human immunodeficiency virus (HIV) diagnoses in the St. Louis metropolitan area, MO, occur predominantly among men who have sex with men (MSM). The Centers for Disease Control and Prevention recommends HIV testing at least annually for sexually active MSM. We examined prevalence and factors associated with recent HIV testing among MSM in the St. Louis area. METHODS: The 2008 National HIV Behavioral Surveillance system recruited men in 21 US metropolitan areas through venue-based, time-space sampling. Men were interviewed for behavioral risks and testing history. The analysis included men in St. Louis who had engaged in male-male sex during the previous year and excluded men who had tested HIV-positive >12 months before the interviews. Factors associated with testing during the previous 12 months were identified using log-binomial regression. RESULTS: Among 339 MSM, 198 (58%) had been tested during the previous 12 months. MSM were more likely to have been tested if they were black (adjusted prevalence ratio [APR]: 1.6; 95% confidence interval [CI]: 1.0-2.5); had visited a health care provider during the previous 12 months (APR: 1.6; 95% CI: 1.3-2.1); or had ever disclosed same-sex attractions or male-male sex to health care providers (APR: 1.6; 95% CI: 1.2-2.0). Of the 141 men who were untested within 12 months, 89 (63%) attributed not testing to perceived low risk. CONCLUSIONS: Nearly half of sexually active MSM in this analysis had not been tested for HIV during the previous year. Annual visits to health care providers during which sexual risk is discussed are likely to promote testing among MSM. |
Outbreak of fatal childhood lead poisoning related to artisanal gold mining in northwestern Nigeria, 2010
Dooyema CA , Neri A , Lo YC , Durant J , Dargan PI , Swarthout T , Biya O , Gidado SO , Haladu S , Sani-Gwarzo N , Nguku PM , Akpan H , Idris S , Bashir AM , Brown MJ . Environ Health Perspect 2011 120 (4) 601-7 BACKGROUND: In May 2010, a team of national and international organizations was assembled to investigate children's deaths due to lead poisoning in villages in northwestern Nigeria. OBJECTIVES: To determine the cause of the childhood lead poisoning outbreak, investigate risk factors for child mortality, and identify children aged <5 years in need of emergency chelation therapy for lead poisoning. METHODS: We administered a cross-sectional, door-to-door questionnaire in two affected villages, collected blood from children aged 2-59 months, and soil samples from family compounds. Descriptive and bivariate analyses were performed with survey, blood-lead, and environmental data. Multivariate logistic regression techniques were used to determine risk factors for childhood mortality. RESULTS: We surveyed 119 family compounds. One hundred eighteen of 463 (25%) children aged <5 years had died in the last year. We tested 59% (204/345) of children, aged <5 years, and all were lead poisoned (≥10 microg/dL); 97% (198/204) of children had blood-lead levels ≥45 microg/dL, the threshold for initiating chelation therapy. Gold ore was processed inside two-thirds of the family compounds surveyed. In multivariate modeling significant risk factors for death in the previous year from suspected lead poisoning included: the child's age, the mother performing ore-processing activities, community well as primary water source, and the soil-lead concentration in the compound. CONCLUSION: The high levels of environmental contamination, percentage of children aged <5 years with elevated blood-lead levels (97%, >45 microg/dL), and incidence of convulsions among children prior to death (82%) suggest that most of the recent childhood deaths in the two surveyed villages were caused by acute lead poisoning from gold ore-processing activities. Control measures included environmental remediation, chelation therapy, public health education, and control of mining activities. |
Severe Leptospirosis similar to pandemic (H1N1) 2009, Florida and Missouri, USA
Lo YC , Kintziger KW , Carson HJ , Patrick SL , Turabelidze G , Stanek D , Blackmore C , Lingamfelter D , Dudley MH , Shadomy SV , Shieh WJ , Drew CP , Batten BC , Zaki SR . Emerg Infect Dis 2011 17 (6) 1145-6 Leptospirosis is caused by pathogenic spirochetes of the genus Leptospira and transmitted through direct contact of skin or mucous membranes with urine or tissues of Leptospira-infected animals or through indirect contact with contaminated freshwater or soil. Leptospirosis shares common clinical signs with influenza, including fever, headache, myalgia, and sometimes cough and gastrointestinal symptoms. During 2009, acute complicated influenza-like illness (ILI) and rapid progressive pneumonia were often attributed to pandemic (H1N1) 2009; however, alternative final diagnoses were reported to be common. We report 3 cases of severe leptospirosis in Florida and Missouri with clinical signs similar to those of pandemic (H1N1) 2009. |
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