Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-30 (of 36 Records) |
Query Trace: Marlow M[original query] |
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Modeling the population-level impact of a third dose of MMR vaccine on a mumps outbreak at the University of Iowa
Park SW , Lawal T , Marin M , Marlow MA , Grenfell BT , Masters NB . Proc Natl Acad Sci U S A 2024 121 (43) e2403808121 Mumps outbreaks among fully vaccinated young adults have raised questions about potential waning of immunity over time and need for a third dose of the measles, mumps, rubella (MMR) vaccine. However, there are currently limited data on real-life effectiveness of the third-dose MMR vaccine in preventing mumps. Here, we used a deterministic compartmental model to infer the effectiveness of the third-dose MMR vaccine in preventing mumps cases by analyzing the mumps outbreak that occurred at the University of Iowa between August 24, 2015, and May 13, 2016. The modeling approach further allowed us to evaluate the population-level impact of vaccination by different timing in relation to the start of the outbreak and varied coverage levels, and to account for potential sources of bias in estimating vaccine effectiveness. We found large uncertainty in vaccine effectiveness estimates; however, our models showed that early introduction of a third dose of MMR vaccine during a mumps outbreak can be effective in preventing transmission. School holidays, such as the winter break, likely played important roles in preventing mumps transmission. |
Design and optimization of novel competitive, non-peptidic, SARS-CoV-2 M(pro) inhibitors
Jacobs L , van der Westhuyzen A , Pribut N , Dentmon ZW , Cui D , D'Erasmo MP , Bartsch PW , Liu K , Cox RM , Greenlund SF , Plemper RK , Mitchell D , Marlow J , Andrews MK , Krueger RE , Sticher ZM , Kolykhalov AA , Natchus MG , Zhou B , Pelly SC , Liotta DC . ACS Med Chem Lett 2023 14 (10) 1434-1440 ![]() ![]() The SARS-CoV-2 main protease (M(pro)) has been proven to be a highly effective target for therapeutic intervention, yet only one drug currently holds FDA approval status for this target. We were inspired by a series of publications emanating from the Jorgensen and Anderson groups describing the design of potent, non-peptidic, competitive SARS-CoV-2 M(pro) inhibitors, and we saw an opportunity to make several design modifications to improve the overall pharmacokinetic profile of these compounds without losing potency. To this end, we created a focused virtual library using reaction-based enumeration tools in the Schrödinger suite. These compounds were docked into the M(pro) active site and subsequently prioritized for synthesis based upon relative binding affinity values calculated by FEP+. Fourteen compounds were selected, synthesized, and evaluated both biochemically and in cell culture. Several of the synthesized compounds proved to be potent, competitive M(pro) inhibitors with improved metabolic stability profiles. |
Enhanced Contact Investigations for Nine Early Travel-Related Cases of SARS-CoV-2 in the United States (preprint)
Burke RM , Balter S , Barnes E , Barry V , Bartlett K , Beer KD , Benowitz I , Biggs HM , Bruce H , Bryant-Genevier J , Cates J , Chatham-Stephens K , Chea N , Chiou H , Christiansen D , Chu VT , Clark S , Cody SH , Cohen M , Conners EE , Dasari V , Dawson P , DeSalvo T , Donahue M , Dratch A , Duca L , Duchin J , Dyal JW , Feldstein LR , Fenstersheib M , Fischer M , Fisher R , Foo C , Freeman-Ponder B , Fry AM , Gant J , Gautom R , Ghinai I , Gounder P , Grigg CT , Gunzenhauser J , Hall AJ , Han GS , Haupt T , Holshue M , Hunter J , Ibrahim MB , Jacobs MW , Jarashow MC , Joshi K , Kamali T , Kawakami V , Kim M , Kirking HL , Kita-Yarbro A , Klos R , Kobayashi M , Kocharian A , Lang M , Layden J , Leidman E , Lindquist S , Lindstrom S , Link-Gelles R , Marlow M , Mattison CP , McClung N , McPherson TD , Mello L , Midgley CM , Novosad S , Patel MT , Pettrone K , Pillai SK , Pray IW , Reese HE , Rhodes H , Robinson S , Rolfes M , Routh J , Rubin R , Rudman SL , Russell D , Scott S , Shetty V , Smith-Jeffcoat SE , Soda EA , Spitters C , Stierman B , Sunenshine R , Terashita D , Traub E , Vahey GM , Verani JR , Wallace M , Westercamp M , Wortham J , Xie A , Yousaf A , Zahn M . medRxiv 2020 2020.04.27.20081901 Background Coronavirus disease 2019 (COVID-19), the respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and has since become pandemic. As part of initial response activities in the United States, enhanced contact investigations were conducted to enable early identification and isolation of additional cases and to learn more about risk factors for transmission.Methods Close contacts of nine early travel-related cases in the United States were identified. Close contacts meeting criteria for active monitoring were followed, and selected individuals were targeted for collection of additional exposure details and respiratory samples. Respiratory samples were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (RT-PCR) at the Centers for Disease Control and Prevention.Results There were 404 close contacts who underwent active monitoring in the response jurisdictions; 338 had at least basic exposure data, of whom 159 had ≥1 set of respiratory samples collected and tested. Across all known close contacts under monitoring, two additional cases were identified; both secondary cases were in spouses of travel-associated case patients. The secondary attack rate among household members, all of whom had ≥1 respiratory sample tested, was 13% (95% CI: 4 – 38%).Conclusions The enhanced contact tracing investigations undertaken around nine early travel-related cases of COVID-19 in the United States identified two cases of secondary transmission, both spouses. Rapid detection and isolation of the travel-associated case patients, enabled by public awareness of COVID-19 among travelers from China, may have mitigated transmission risk among close contacts of these cases.Competing Interest StatementThe authors have declared no competing interest.Funding StatementNo external funding was sought or received.Author DeclarationsAll relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript.YesAll necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesData may be available upon reasonable request. |
Mumps vaccine effectiveness of a 3rd dose of measles, mumps, rubella vaccine in school settings during a mumps outbreak -- Arkansas, 2016-2017
Guo A , Leung J , Ayers T , Fields VS , Safi H , Waters C , Curns AT , Routh JA , Haselow DT , Marlow MA , Marin M . Public Health Pract (Oxf) 2023 6 100404 Objectives: The largest mumps outbreak in the United States since 2006 occurred in Arkansas during the 2016-17 school year. An additional dose (third dose) of measles-mumps-rubella vaccine (MMR3) was offered to school children. We evaluated the vaccine effectiveness (VE) of MMR3 compared with two doses of MMR for preventing mumps among school-aged children during the outbreak. Study design: A generalized linear mixed effects model was used to estimate the incremental vaccine effectiveness (VE) of a third dose of MMR compared with two doses of MMR for preventing mumps. Methods: We obtained school enrollment, immunization status and mumps case status from school registries, Arkansas's immunization registry, and Arkansas's mumps surveillance system, respectively. We included students who previously received 2 doses of MMR in schools with ≥1 mumps case after the MMR3 clinic. We used a generalized linear mixed model to estimate VE of MMR3 compared with two doses of MMR. Results: Sixteen schools with 9272 students were included in the analysis. Incremental VE of MMR3 versus a two-dose MMR regimen was 52.7% (95% confidence interval [CI]: -3.6%‒78.4%) overall and in 8 schools with high mumps transmission it was 64.0% (95% CI: 1.2%‒86.9%). MMR3 VE was higher among middle compared with elementary school students (68.5% [95% CI: -30.2%‒92.4%] vs 37.6% [95% CI: -62.5%‒76.1%]); these differences were not statistically significant. Conclusion: Our findings suggest MMR3 provided additional protection from mumps compared with two MMR doses in elementary and middle school settings during a mumps outbreak. © 2023 |
Initial public health response and interim clinical guidance for the 2019 novel coronavirus outbreak - United States, December 31, 2019-February 4, 2020.
Patel A , Jernigan DB , 2019-nCOV CDC Response Team , Abdirizak Fatuma , Abedi Glen , Aggarwal Sharad , Albina Denise , Allen Elizabeth , Andersen Lauren , Anderson Jade , Anderson Megan , Anderson Tara , Anderson Kayla , Bardossy Ana Cecilia , Barry Vaughn , Beer Karlyn , Bell Michael , Berger Sherri , Bertulfo Joseph , Biggs Holly , Bornemann Jennifer , Bornstein Josh , Bower Willie , Bresee Joseph , Brown Clive , Budd Alicia , Buigut Jennifer , Burke Stephen , Burke Rachel , Burns Erin , Butler Jay , Cantrell Russell , Cardemil Cristina , Cates Jordan , Cetron Marty , Chatham-Stephens Kevin , Chatham-Stevens Kevin , Chea Nora , Christensen Bryan , Chu Victoria , Clarke Kevin , Cleveland Angela , Cohen Nicole , Cohen Max , Cohn Amanda , Collins Jennifer , Conners Erin , Curns Aaron , Dahl Rebecca , Daley Walter , Dasari Vishal , Davlantes Elizabeth , Dawson Patrick , Delaney Lisa , Donahue Matthew , Dowell Chad , Dyal Jonathan , Edens William , Eidex Rachel , Epstein Lauren , Evans Mary , Fagan Ryan , Farris Kevin , Feldstein Leora , Fox LeAnne , Frank Mark , Freeman Brandi , Fry Alicia , Fuller James , Galang Romeo , Gerber Sue , Gokhale Runa , Goldstein Sue , Gorman Sue , Gregg William , Greim William , Grube Steven , Hall Aron , Haynes Amber , Hill Sherrasa , Hornsby-Myers Jennifer , Hunter Jennifer , Ionta Christopher , Isenhour Cheryl , Jacobs Max , Jacobs Slifka Kara , Jernigan Daniel , Jhung Michael , Jones-Wormley Jamie , Kambhampati Anita , Kamili Shifaq , Kennedy Pamela , Kent Charlotte , Killerby Marie , Kim Lindsay , Kirking Hannah , Koonin Lisa , Koppaka Ram , Kosmos Christine , Kuhar David , Kuhnert-Tallman Wendi , Kujawski Stephanie , Kumar Archana , Landon Alexander , Lee Leslie , Leung Jessica , Lindstrom Stephen , Link-Gelles Ruth , Lively Joana , Lu Xiaoyan , Lynch Brian , Malapati Lakshmi , Mandel Samantha , Manns Brian , Marano Nina , Marlow Mariel , Marston Barbara , McClung Nancy , McClure Liz , McDonald Emily , McGovern Oliva , Messonnier Nancy , Midgley Claire , Moulia Danielle , Murray Janna , Noelte Kate , Noonan-Smith Michelle , Nordlund Kristen , Norton Emily , Oliver Sara , Pallansch Mark , Parashar Umesh , Patel Anita , Patel Manisha , Pettrone Kristen , Pierce Taran , Pietz Harald , Pillai Satish , Radonovich Lewis , Reagan-Steiner Sarah , Reel Amy , Reese Heather , Rha Brian , Ricks Philip , Rolfes Melissa , Roohi Shahrokh , Roper Lauren , Rotz Lisa , Routh Janell , Sakthivel Senthil Kumar Sarmiento Luisa , Schindelar Jessica , Schneider Eileen , Schuchat Anne , Scott Sarah , Shetty Varun , Shockey Caitlin , Shugart Jill , Stenger Mark , Stuckey Matthew , Sunshine Brittany , Sykes Tamara , Trapp Jonathan , Uyeki Timothy , Vahey Grace , Valderrama Amy , Villanueva Julie , Walker Tunicia , Wallace Megan , Wang Lijuan , Watson John , Weber Angie , Weinbaum Cindy , Weldon William , Westnedge Caroline , Whitaker Brett , Whitaker Michael , Williams Alcia , Williams Holly , Willams Ian , Wong Karen , Xie Amy , Yousef Anna . Am J Transplant 2020 20 (3) 889-895 This article summarizes what is currently known about the 2019 novel coronavirus and offers interim guidance. |
Impact of vaccine effectiveness and coverage on preventing large mumps outbreaks on college campuses: Implications for vaccination strategy
Melgar M , Yockey B , Marlow MA . Epidemics 2022 40 100594 Recent mumps outbreaks among highly vaccinated populations, including college students, have called into question the vaccine effectiveness (VE) of routine two-dose measles, mumps, and rubella (MMR2) immunization. We aimed to estimate the VE required for a novel vaccination strategy (e.g., MMR booster dose, novel vaccine) to prevent large mumps outbreaks on college campuses. Using mumps college outbreak data reported to the U.S. Centers for Disease Control and Prevention during 2016-2017, we estimated current MMR2 VE using the screening method and implemented a compartmental model of mumps transmission. We performed 2000 outbreak simulations, following introduction of an infectious person to a population of 10,000, over ranges of MMR2 vaccine coverage (VC) and VE (30.0-99.0%). We compared the impact of varying VC and VE on mumps and mumps orchitis case counts and determined VE thresholds that ensured < 5.0% and < 2.0% of the outbreak simulations exceeded 20 and 100 mumps cases. Median estimated MMR2 VE in reported mumps outbreaks was 60.5% and median reported MMR2 VC was 97.5%. Simulated mumps case count was more sensitive to changes in VE than in VC. The opposite was true for simulated mumps orchitis case count, though orchitis case count was small (mean <10 cases across simulations for VE near 60.5% and VC near 97.5%). At 97.5% VC, 73.1% and 78.2% VE were required for < 5.0% and < 2.0% of outbreaks, respectively, to exceed 100 mumps cases. Maintaining 97.5% VC, 82.4% and 85.9% VE were required for < 5.0% and < 2.0% of outbreaks, respectively, to exceed 20 cases. We conclude that maintaining current levels of MMR2 VC, a novel vaccination strategy aimed at reducing mumps transmission must achieve at least 73.1-85.9% VE among young adults to prevent large mumps outbreaks on college campuses. |
Mumps in vaccinated children and adolescents: 2007-2019
Shepersky L , Marin M , Zhang J , Pham H , Marlow MA . Pediatrics 2021 148 (6) BACKGROUND: Despite a >99% reduction in US mumps cases after the introduction of mumps vaccine in 1967, outbreaks have occurred in schools and other settings involving vaccinated children and adolescents since 2006. METHODS: We analyzed mumps cases reported by US health departments to the National Notifiable Diseases Surveillance System. We present the incidence and vaccination status of pediatric cases (age <18 years) during 2007-2019 and describe demographic, clinical, and vaccination characteristics of pediatric cases reported during the most recent resurgence in 2015-2019. RESULTS: During 2007-2019, 9172 pediatric cases were reported, accounting for a median of 32% of all cases reported each year (range: 13%-59%). A median of 87% (range: 81%-94%) of pediatric patients each year had previously received ≥1 measles, mumps, and rubella (MMR) vaccine dose. During 2015-2019, of 5461 pediatric cases reported, only 2% of those with known import status (74%) were associated with international travel. One percent of patients had complications and 2% were hospitalized. Among patients aged ≥1 year with known vaccination status (72%), 74% of 1- to 4-year-olds had received ≥1 MMR dose and 86% of 5- to 17-year-olds had received ≥2 MMR doses. Since 2016, pediatric mumps cases have been reported in most US states each year (range: 38-45 states). CONCLUSIONS: Since 2007, one-third of US reported mumps cases occurred in children and adolescents, the majority of whom were vaccinated. Clinicians should suspect mumps in patients with parotitis or mumps complications, regardless of age, travel history, and vaccination status. |
Mild botulism from illicitly brewed alcohol in a large prison outbreak in Mississippi
Marlow M , Edwards L , McCrickard L , Francois Watkins LK , Anderson J , Hand S , Taylor K , Dykes J , Byers P , Chatham-Stephens K . Front Public Health 2021 9 716615 Botulism is typically described as a rapidly progressing, severe neuroparalytic disease. Foodborne botulism is transmitted through consuming food or drink that has been contaminated with botulinum toxin. During a botulism outbreak linked to illicitly brewed alcohol (also known as "hooch" or "pruno") in a prison, 11 (35%) of 31 inmates that consumed contaminated hooch had mild illnesses. This includes 2 inmates with laboratory confirmed botulism. The most frequently reported signs and symptoms among the 11 patients with mild illness included dry mouth (91%), hoarse voice (91%), difficulty swallowing (82%), fatigue (82%), and abdominal pain (82%). Foodborne botulism is likely underdiagnosed and underreported in patients with mild illness. Botulism should be considered on the differential diagnosis for patients with cranial nerve palsies. |
Pediatricians' knowledge and practices related to mumps diagnosis and prevention
Cataldi JR , O'Leary ST , Marlow MA , Beaty BL , Hurley LP , Crane LA , Brtnikova M , Gorman C , Pham HT , Lindley MC , Kempe A . J Pediatr 2021 239 81-88 e2 OBJECTIVES: To assess pediatricians' mumps knowledge and testing practices, to identify physician and practice characteristics associated with mumps testing practices, and to assess reporting and outbreak response knowledge and practices. STUDY DESIGN: From January-April 2020, we surveyed a nationally representative network of pediatricians. Descriptive statistics were generated for all items. Chi-square, t-tests, and Poisson regression were used to compare physician and practice characteristics between respondents who would rarely or never vs. sometimes or often/always test for mumps in a vaccinated 17-year-old with parotitis in a non-outbreak setting. RESULTS: The response rate was 67% (297/444). For knowledge, over half of pediatricians responded incorrectly or 'Don't know' for six of nine true/false statements about mumps epidemiology, diagnosis, and prevention; and over half reported they would need additional guidance on mumps buccal swab testing. For testing practices, 59% of respondents reported they would sometimes (35%) or often/always (24%) test for mumps in a vaccinated 17-year-old with parotitis in a non-outbreak setting; older physicians, rural physicians, and physicians from the Northeast or Midwest were more likely to test for mumps. Thirty-six percent of pediatricians reported they would often/always report a patient with suspected mumps to public health authorities. CONCLUSIONS: Pediatricians report mumps knowledge gaps and practices that do not align with public health recommendations. These gaps may lead to under-diagnosis and under-reporting of mumps cases, delaying public health response measures and contributing to ongoing disease transmission. |
Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May-June, 2020.
Wallace M , James AE , Silver R , Koh M , Tobolowsky FA , Simonson S , Gold JAW , Fukunaga R , Njuguna H , Bordelon K , Wortham J , Coughlin M , Harcourt JL , Tamin A , Whitaker B , Thornburg NJ , Tao Y , Queen K , Uehara A , Paden CR , Zhang J , Tong S , Haydel D , Tran H , Kim K , Fisher KA , Marlow M , Tate JE , Doshi RH , Sokol T , Curran KG . Emerg Infect Dis 2021 27 (2) 421-429 To assess transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a detention facility experiencing a coronavirus disease outbreak and evaluate testing strategies, we conducted a prospective cohort investigation in a facility in Louisiana, USA. We conducted SARS-CoV-2 testing for detained persons in 6 quarantined dormitories at various time points. Of 143 persons, 53 were positive at the initial test, and an additional 58 persons were positive at later time points (cumulative incidence 78%). In 1 dormitory, all 45 detained persons initially were negative; 18 days later, 40 (89%) were positive. Among persons who were SARS-CoV-2 positive, 47% (52/111) were asymptomatic at the time of specimen collection; 14 had replication-competent virus isolated. Serial SARS-CoV-2 testing might help interrupt transmission through medical isolation and quarantine. Testing in correctional and detention facilities will be most effective when initiated early in an outbreak, inclusive of all exposed persons, and paired with infection prevention and control. |
Enhanced contact investigations for nine early travel-related cases of SARS-CoV-2 in the United States.
Burke RM , Balter S , Barnes E , Barry V , Bartlett K , Beer KD , Benowitz I , Biggs HM , Bruce H , Bryant-Genevier J , Cates J , Chatham-Stephens K , Chea N , Chiou H , Christiansen D , Chu VT , Clark S , Cody SH , Cohen M , Conners EE , Dasari V , Dawson P , DeSalvo T , Donahue M , Dratch A , Duca L , Duchin J , Dyal JW , Feldstein LR , Fenstersheib M , Fischer M , Fisher R , Foo C , Freeman-Ponder B , Fry AM , Gant J , Gautom R , Ghinai I , Gounder P , Grigg CT , Gunzenhauser J , Hall AJ , Han GS , Haupt T , Holshue M , Hunter J , Ibrahim MB , Jacobs MW , Jarashow MC , Joshi K , Kamali T , Kawakami V , Kim M , Kirking HL , Kita-Yarbro A , Klos R , Kobayashi M , Kocharian A , Lang M , Layden J , Leidman E , Lindquist S , Lindstrom S , Link-Gelles R , Marlow M , Mattison CP , McClung N , McPherson TD , Mello L , Midgley CM , Novosad S , Patel MT , Pettrone K , Pillai SK , Pray IW , Reese HE , Rhodes H , Robinson S , Rolfes M , Routh J , Rubin R , Rudman SL , Russell D , Scott S , Shetty V , Smith-Jeffcoat SE , Soda EA , Spitters C , Stierman B , Sunenshine R , Terashita D , Traub E , Vahey GM , Verani JR , Wallace M , Westercamp M , Wortham J , Xie A , Yousaf A , Zahn M . PLoS One 2020 15 (9) e0238342 Coronavirus disease 2019 (COVID-19), the respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and has since become pandemic. In response to the first cases identified in the United States, close contacts of confirmed COVID-19 cases were investigated to enable early identification and isolation of additional cases and to learn more about risk factors for transmission. Close contacts of nine early travel-related cases in the United States were identified and monitored daily for development of symptoms (active monitoring). Selected close contacts (including those with exposures categorized as higher risk) were targeted for collection of additional exposure information and respiratory samples. Respiratory samples were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction at the Centers for Disease Control and Prevention. Four hundred four close contacts were actively monitored in the jurisdictions that managed the travel-related cases. Three hundred thirty-eight of the 404 close contacts provided at least basic exposure information, of whom 159 close contacts had ≥1 set of respiratory samples collected and tested. Across all actively monitored close contacts, two additional symptomatic COVID-19 cases (i.e., secondary cases) were identified; both secondary cases were in spouses of travel-associated case patients. When considering only household members, all of whom had ≥1 respiratory sample tested for SARS-CoV-2, the secondary attack rate (i.e., the number of secondary cases as a proportion of total close contacts) was 13% (95% CI: 4-38%). The results from these contact tracing investigations suggest that household members, especially significant others, of COVID-19 cases are at highest risk of becoming infected. The importance of personal protective equipment for healthcare workers is also underlined. Isolation of persons with COVID-19, in combination with quarantine of exposed close contacts and practice of everyday preventive behaviors, is important to mitigate spread of COVID-19. |
Mumps cases disproportionately affecting persons living with HIV infection and men who have sex with men - Chicago, Illinois, 2018
McPherson TD , Ramirez E , Ringness M , Ruestow P , Marlow M , Fricchione MJ . MMWR Morb Mortal Wkly Rep 2020 69 (28) 909-912 During January 1-March 2, 2018, the number of mumps cases among adults reported to the Chicago Department of Public Health (CDPH) doubled compared with the same period in 2017. In response, CDPH created a supplementary questionnaire to collect additional information on populations affected and potential transmission routes. An epidemiologic analysis of routine and supplementary data, including spatiotemporal analysis, was performed to describe mumps cases reported to CDPH during 2018. A fourfold increase in mumps cases was reported during 2018 compared with 2017, with men who have sex with men (MSM) and persons living with human immunodeficiency virus (HIV) infection disproportionately represented among cases. A spatiotemporal, residential cluster was identified in a 9-square-mile area within six adjacent communities. The majority of persons affected were MSM, and this area was visited by many other persons with mumps diagnoses. Spatiotemporal analyses could be used in real time to identify case clusters to target public health response efforts, including to guide recommendations for additional measles, mumps, and rubella (MMR) vaccine and to identify specific transmission venues. |
Serial Laboratory Testing for SARS-CoV-2 Infection Among Incarcerated and Detained Persons in a Correctional and Detention Facility - Louisiana, April-May 2020.
Njuguna H , Wallace M , Simonson S , Tobolowsky FA , James AE , Bordelon K , Fukunaga R , Gold JAW , Wortham J , Sokol T , Haydel D , Tran H , Kim K , Fisher KA , Marlow M , Tate JE , Doshi RH , Curran KG . MMWR Morb Mortal Wkly Rep 2020 69 (26) 836-840 Transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by asymptomatic and presymptomatic persons poses important challenges to controlling spread of the disease, particularly in congregate settings such as correctional and detention facilities (1). On March 29, 2020, a staff member in a correctional and detention facility in Louisiana developed symptoms(dagger) and later had a positive test result for SARS-CoV-2. During April 2-May 7, two additional cases were detected among staff members, and 36 cases were detected among incarcerated and detained persons at the facility; these persons were removed from dormitories and isolated, and the five dormitories that they had resided in before diagnosis were quarantined. On May 7, CDC and the Louisiana Department of Health initiated an investigation to assess the prevalence of SARS-CoV-2 infection among incarcerated and detained persons residing in quarantined dormitories. Goals of this investigation included evaluating COVID-19 symptoms in this setting and assessing the effectiveness of serial testing to identify additional persons with SARS-CoV-2 infection as part of efforts to mitigate transmission. During May 7-21, testing of 98 incarcerated and detained persons residing in the five quarantined dormitories (A-E) identified an additional 71 cases of SARS-CoV-2 infection; 32 (45%) were among persons who reported no symptoms at the time of testing, including three who were presymptomatic. Eighteen cases (25%) were identified in persons who had received negative test results during previous testing rounds. Serial testing of contacts from shared living quarters identified persons with SARS-CoV-2 infection who would not have been detected by symptom screening alone or by testing at a single time point. Prompt identification and isolation of infected persons is important to reduce further transmission in congregate settings such as correctional and detention facilities and the communities to which persons return when released. |
Investigation and Serologic Follow-Up of Contacts of an Early Confirmed Case-Patient with COVID-19, Washington, USA.
Chu VT , Freeman-Ponder B , Lindquist S , Spitters C , Kawakami V , Dyal JW , Clark S , Bruce H , Duchin JS , DeBolt C , Podczervinski S , D'Angeli M , Pettrone K , Zacks R , Vahey G , Holshue ML , Lang M , Burke RM , Rolfes MA , Marlow M , Midgley CM , Lu X , Lindstrom S , Hall AJ , Fry AM , Thornburg NJ , Gerber SI , Pillai SK , Biggs HM . Emerg Infect Dis 2020 26 (8) 1671-1678 We describe the contact investigation for an early confirmed case of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the United States. Contacts of the case-patient were identified, actively monitored for symptoms, interviewed for a detailed exposure history, and tested for SARS-CoV-2 infection by real-time reverse transcription PCR (rRT-PCR) and ELISA. Fifty contacts were identified and 38 (76%) were interviewed, of whom 11 (29%) reported unprotected face-to-face interaction with the case-patient. Thirty-seven (74%) had respiratory specimens tested by rRT-PCR, and all tested negative. Twenty-three (46%) had ELISA performed on serum samples collected approximately 6 weeks after exposure, and none had detectable antibodies to SARS-CoV-2. Among contacts who were tested, no secondary transmission was identified in this investigation, despite unprotected close interactions with the infectious case-patient. |
COVID-19 in Correctional and Detention Facilities - United States, February-April 2020.
Wallace M , Hagan L , Curran KG , Williams SP , Handanagic S , Bjork A , Davidson SL , Lawrence RT , McLaughlin J , Butterfield M , James AE , Patil N , Lucas K , Hutchinson J , Sosa L , Jara A , Griffin P , Simonson S , Brown CM , Smoyer S , Weinberg M , Pattee B , Howell M , Donahue M , Hesham S , Shelley E , Philips G , Selvage D , Staley EM , Lee A , Mannell M , McCotter O , Villalobos R , Bell L , Diedhiou A , Ortbahn D , Clayton JL , Sanders K , Cranford H , Barbeau B , McCombs KG , Holsinger C , Kwit NA , Pringle JC , Kariko S , Strick L , Allord M , Tillman C , Morrison A , Rowe D , Marlow M . MMWR Morb Mortal Wkly Rep 2020 69 (19) 587-590 An estimated 2.1 million U.S. adults are housed within approximately 5,000 correctional and detention facilities(dagger) on any given day (1). Many facilities face significant challenges in controlling the spread of highly infectious pathogens such as SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Such challenges include crowded dormitories, shared lavatories, limited medical and isolation resources, daily entry and exit of staff members and visitors, continual introduction of newly incarcerated or detained persons, and transport of incarcerated or detained persons in multiperson vehicles for court-related, medical, or security reasons (2,3). During April 22-28, 2020, aggregate data on COVID-19 cases were reported to CDC by 37 of 54 state and territorial health department jurisdictions. Thirty-two (86%) jurisdictions reported at least one laboratory-confirmed case from a total of 420 correctional and detention facilities. Among these facilities, COVID-19 was diagnosed in 4,893 incarcerated or detained persons and 2,778 facility staff members, resulting in 88 deaths in incarcerated or detained persons and 15 deaths among staff members. Prompt identification of COVID-19 cases and consistent application of prevention measures, such as symptom screening and quarantine, are critical to protecting incarcerated and detained persons and staff members. |
Public Health Response to COVID-19 Cases in Correctional and Detention Facilities - Louisiana, March-April 2020.
Wallace M , Marlow M , Simonson S , Walker M , Christophe N , Dominguez O , Kleamenakis L , Orellana A , Pagan-Pena D , Singh C , Pogue M , Saucier L , Lo T , Benson K , Sokol T . MMWR Morb Mortal Wkly Rep 2020 69 (19) 594-598 Correctional and detention facilities face unique challenges in the control of infectious diseases, including coronavirus disease 2019 (COVID-19) (1-3). Among >10 million annual admissions to U.S. jails, approximately 55% of detainees are released back into their communities each week (4); in addition, staff members at correctional and detention facilities are members of their local communities. Thus, high rates of COVID-19 in correctional and detention facilities also have the potential to influence broader community transmission. In March 2020, the Louisiana Department of Health (LDH) began implementing surveillance for COVID-19 among correctional and detention facilities in Louisiana and identified cases and outbreaks in many facilities. In response, LDH and CDC developed and deployed the COVID-19 Management Assessment and Response (CMAR) tool to guide technical assistance focused on infection prevention and control policies and case management with correctional and detention facilities. This report describes COVID-19 prevalence in correctional and detention facilities detected through surveillance and findings of the CMAR assessment. During March 25-April 22, 489 laboratory-confirmed COVID-19 cases, including 37 (7.6%) hospitalizations and 10 (2.0%) deaths among incarcerated or detained persons, and 253 cases, including 19 (7.5%) hospitalizations and four (1.6%) deaths among staff members were reported. During April 8-22, CMAR telephone-based assessments were conducted with 13 of 31 (42%) facilities with laboratory-confirmed cases and 11 of 113 (10%) facilities without known cases. Administrators had awareness and overall understanding of CDC guidance for prevention of transmission in these facilities but reported challenges in implementation, related to limited space to quarantine close contacts of COVID-19 patients and inability of incarcerated and detained persons to engage in social distancing, particularly in dormitory-style housing. CMAR was a useful tool that helped state and federal public health officials assist multiple correctional and detention facilities to better manage COVID-19 patients and guide control activities to prevent or mitigate transmission. |
Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States.
Kujawski SA , Wong KK , Collins JP , Epstein L , Killerby ME , Midgley CM , Abedi GR , Ahmed NS , Almendares O , Alvarez FN , Anderson KN , Balter S , Barry V , Bartlett K , Beer K , Ben-Aderet MA , Benowitz I , Biggs HM , Binder AM , Black SR , Bonin B , Bozio CH , Brown CM , Bruce H , Bryant-Genevier J , Budd A , Buell D , Bystritsky R , Cates J , Charles EM , Chatham-Stephens K , Chea N , Chiou H , Christiansen D , Chu V , Cody S , Cohen M , Conners EE , Curns AT , Dasari V , Dawson P , DeSalvo T , Diaz G , Donahue M , Donovan S , Duca LM , Erickson K , Esona MD , Evans S , Falk J , Feldstein LR , Fenstersheib M , Fischer M , Fisher R , Foo C , Fricchione MJ , Friedman O , Fry A , Galang RR , Garcia MM , Gerber SI , Gerrard G , Ghinai I , Gounder P , Grein J , Grigg C , Gunzenhauser JD , Gutkin GI , Haddix M , Hall AJ , Han GS , Harcourt J , Harriman K , Haupt T , Haynes AK , Holshue M , Hoover C , Hunter JC , Jacobs MW , Jarashow C , Joshi K , Kamali T , Kamili S , Kim L , Kim M , King J , Kirking HL , Kita-Yarbro A , Klos R , Kobayashi M , Kocharian A , Komatsu KK , Koppaka R , Layden JE , Li Y , Lindquist S , Lindstrom S , Link-Gelles R , Lively J , Livingston M , Lo K , Lo J , Lu X , Lynch B , Madoff L , Malapati L , Marks G , Marlow M , Mathisen GE , McClung N , McGovern O , McPherson TD , Mehta M , Meier A , Mello L , Moon SS , Morgan M , Moro RN , Murray J , Murthy R , Novosad S , Oliver SE , O’Shea J , Pacilli M , Paden CR , Pallansch MA , Patel M , Patel S , Pedraza I , Pillai SK , Pindyck T , Pray I , Queen K , Quick N , Reese H , Reporter R , Rha B , Rhodes H , Robinson S , Robinson P , Rolfes MA , Routh JA , Rubin R , Rudman SL , Sakthivel SK , Scott S , Shepherd C , Shetty V , Smith EA , Smith S , Stierman B , Stoecker W , Sunenshine R , Sy-Santos R , Tamin A , Tao Y , Terashita D , Thornburg NJ , Tong S , Traub E , Tural A , Uehara A , Uyeki TM , Vahey G , Verani JR , Villarino E , Wallace M , Wang L , Watson JT , Westercamp M , Whitaker B , Wilkerson S , Woodruff RC , Wortham JM , Wu T , Xie A , Yousaf A , Zahn M , Zhang J . Nat Med 2020 26 (6) 861-868 Data on the detailed clinical progression of COVID-19 in conjunction with epidemiological and virological characteristics are limited. In this case series, we describe the first 12 US patients confirmed to have COVID-19 from 20 January to 5 February 2020, including 4 patients described previously(1-3). Respiratory, stool, serum and urine specimens were submitted for SARS-CoV-2 real-time reverse-transcription polymerase chain reaction (rRT-PCR) testing, viral culture and whole genome sequencing. Median age was 53 years (range: 21-68); 8 patients were male. Common symptoms at illness onset were cough (n = 8) and fever (n = 7). Patients had mild to moderately severe illness; seven were hospitalized and demonstrated clinical or laboratory signs of worsening during the second week of illness. No patients required mechanical ventilation and all recovered. All had SARS-CoV-2 RNA detected in respiratory specimens, typically for 2-3 weeks after illness onset. Lowest real-time PCR with reverse transcription cycle threshold values in the upper respiratory tract were often detected in the first week and SARS-CoV-2 was cultured from early respiratory specimens. These data provide insight into the natural history of SARS-CoV-2. Although infectiousness is unclear, highest viral RNA levels were identified in the first week of illness. Clinicians should anticipate that some patients may worsen in the second week of illness. |
Universities' experience with mumps outbreak response and use of a third dose of MMR vaccine
Marlow M , Even S , Hoban MT , Moore K , Patel M , Marin M . J Am Coll Health 2019 69 (1) 1-6 Objective: During January 2016-June 2017, 75 mumps outbreaks occurred in US universities, despite high vaccine coverage among students. We evaluated universities' experiences with mumps outbreaks to inform policy deliberations on use of a third dose of MMR vaccine and CDC guidance. Participants: American College Health Association members in September 2017. Methods: Online survey assessing mumps outbreak characteristics and response measures distributed to 980 members. Results: Administrators from 251 (26%) universities from 47 states responded. Seventy-nine (31%) universities had mumps cases on campus during August 2014-August 2017; 17 (22%) recommended a third MMR dose. The main challenges reported in outbreak response were exclusion of persons without presumptive immunity and isolation of students with mumps. Universities' advice on addressing challenges is described. Conclusion: We identified common challenges faced by universities during mumps outbreaks, and lessons learned. These findings informed the October 2017 recommendation for use of a third MMR dose. |
Notes from the field: Mumps in detention facilities that house detained migrants - United States, September 2018-August 2019
Leung J , Elson D , Sanders K , Marin M , Leos G , Cloud B , McNall RJ , Hickman CJ , Marlow M . MMWR Morb Mortal Wkly Rep 2019 68 (34) 749-750 On October 12, 2018, five confirmed cases of mumps among migrants who had been transferred between two detention facilities were reported by the facilities to the Texas Department of State Health Services (TDSHS). By December 11, eight Texas detention facilities and six facilities in five other states had reported 67 mumps cases to U.S. Immigration and Customs Enforcement (ICE) Health Service Corps (IHSC) or local health departments. On December 12, TDSHS contacted CDC to discuss mumps control in detention facilities and facilitate communication with IHSC. During January 4–17, 2019, six more state health departments reported new cases in detention facilities, which prompted CDC and IHSC to launch a coordinated national outbreak response. |
Workplace interventions for intimate partner violence: A systematic review
Adhia A , Gelaye B , Friedman LE , Marlow LY , Mercy JA , Williams MA . J Workplace Behav Health 2019 34 (3) 149-166 Workplace interventions represent important opportunities to increase awareness of and adherence to disease prevention and health promotion initiatives. However, research on workplace interventions for intimate partner violence (IPV) has not been systematically evaluated. This systematic review summarizes existing studies evaluating workplace interventions for IPV. PubMed, PsycINFO, Business Source Complete, Web of Science, and Social Services Abstracts were systematically searched for English-language studies published before November 2017. Six studies evaluating five interventions were included. Only one study used a randomized design, and only two studies measured whether outcomes were sustained over time. None of the interventions addressed perpetrators of IPV. Interventions focused on recognizing signs of abuse, responding to victims, and providing referrals to community-based resources. Methodological rigor of included studies varied, but all reported at least one intervention-related benefit. Findings included improved awareness of IPV, increased provision of information to victims, and greater willingness to intervene if an employee may be experiencing IPV. Although sparse, available evidence suggests there are potential benefits of workplace interventions for IPV. It is important for future interventions to focus on primary and secondary prevention of IPV and address perpetration, and for investigators to use rigorous study designs and measure whether effects are sustained. |
CDC guidance for use of a third dose of MMR vaccine during mumps outbreaks
Marlow MA , Marin M , Moore K , Patel M . J Public Health Manag Pract 2019 26 (2) 109-115 CONTEXT: In response to numerous mumps outbreaks reported throughout the United States in 2016 and 2017, the Advisory Committee on Immunization Practices (ACIP) recommended a third dose of measles, mumps, and rubella (MMR) vaccine for groups of persons determined by public health authorities to be at increased risk for acquiring mumps because of an outbreak. OBJECTIVE: To provide guidance for health departments when implementing the ACIP recommendation. DESIGN: Draft guidance was developed by Centers for Disease Control and Prevention subject matter experts based on technical consultations with health departments and review of published and unpublished data regarding mumps outbreaks. The guidance was finalized based on input from experts from the ACIP Mumps Work Group and local and state epidemiologists through the Council of State and Territorial Epidemiologists and the National Association of County and City Health Officials. RESULTS: We developed guidance to assist public health authorities when determining which groups are at increased risk for acquiring mumps and should receive a third dose of MMR vaccine. During outbreaks, public health authorities identify groups of persons with known or likely close contact exposure to a mumps patient. Then, evidence of transmission and likelihood of transmission in a group's setting can be used to determine whether these groups are at increased risk. Additional epidemiologic and implementation factors may also be considered. All persons in the group at increased risk for acquiring mumps should receive a dose of MMR vaccine, including those with unknown vaccination status or those who have evidence of presumptive immunity other than documented 2 doses of MMR vaccine; no additional dose is recommended for persons who had received 3 or more doses before the outbreak. CONCLUSION: This guidance provides a framework for public health authorities to use when considering a third dose of MMR in response to mumps outbreaks while maintaining flexibility to incorporate local factors related to individual outbreaks. |
Health departments' experience with mumps outbreak response and use of a third dose of measles, mumps, and rubella vaccine
Marlow MA , Moore K , DeBolt C , Patel M , Marin M . J Public Health Manag Pract 2019 26 (2) 101-108 CONTEXT: During January 2016 to June 2017, US health departments (HDs) reported 150 mumps outbreaks. Most occurred among populations with high 2-dose measles, mumps, and rubella (MMR) vaccine coverage, prompting the Advisory Committee on Immunization Practices to examine the evidence for use of a third dose of MMR vaccine. OBJECTIVE: To evaluate HD experiences with mumps outbreak control and use of a third MMR dose during outbreaks. DESIGN: An online survey assessing mumps outbreak characteristics, outbreak response measures, challenges, and lessons learned from previous outbreaks was distributed to all 81 Council of State and Territorial Epidemiologists member HDs in August 2017. RESULTS: Sixty-one (75%) HDs responded; 46 (75%) had experience with >/=1 mumps outbreak(s) during January 2016 to August 2017. Twenty (43%) HDs recommended a third or outbreak MMR dose during mumps outbreaks; of these, 19 completed the section on use of a third dose and 8 (40%) rated the intervention "somewhat effective" or better. Health departments that used a third/outbreak dose suggested implementing the recommendation early and to a targeted group. Forty-three (73%) HDs reported having a policy for excluding persons without presumptive immunity from outbreak settings; of these, 37 (86%) had some degree of legal authority to implement this policy. Exclusion compliance improved with the use of personalized notification letters, focus groups of excluded persons and the community, and standardized messaging. Other outbreak control measures included cohorting of exposed or susceptible persons, mobile vaccination clinics and home visits, contact monitoring via text messaging, and facilitating student isolation with meal delivery and excused class absences. CONCLUSIONS: Our study revealed heterogeneity across HDs' mumps outbreak responses but also identified common challenges that will inform future Centers for Disease Control and Prevention guidance. These results were considered in the October 2017 Advisory Committee on Immunization Practices recommendation for use of a third dose of MMR vaccine for persons at increased risk for mumps during an outbreak and in the development of Centers for Disease Control and Prevention guidance for HDs when applying the Advisory Committee on Immunization Practices recommendation. |
Recommendation of the Advisory Committee on Immunization Practices for use of a third dose of mumps virus-containing vaccine in persons at increased risk for mumps during an outbreak
Marin M , Marlow M , Moore KL , Patel M . MMWR Morb Mortal Wkly Rep 2018 67 (1) 33-38 A substantial increase in the number of mumps outbreaks and outbreak-associated cases has occurred in the United States since late 2015 (1,2). To address this public health problem, the Advisory Committee on Immunization Practices (ACIP) reviewed the available evidence and determined that a third dose of measles, mumps, rubella (MMR) vaccine is safe and effective at preventing mumps. During its October 2017 meeting, ACIP recommended a third dose of a mumps virus-containing vaccine* for persons previously vaccinated with 2 doses who are identified by public health authorities as being part of a group or population at increased risk for acquiring mumps because of an outbreak. The purpose of the recommendation is to improve protection of persons in outbreak settings against mumps disease and mumps-related complications. This recommendation supplements the existing ACIP recommendations for mumps vaccination (3). |
Effect of ventilation velocity on hexavalent chromium and isocyanate exposures in aircraft paint spraying
Bennett J , Marlow D , Nourian F , Breay J , Feng A , Methner M . J Occup Environ Hyg 2017 15 (3) 0 Exposure control system performance was evaluated during aircraft paint spraying at a military facility. Computational fluid dynamics (CFD) modeling, tracer gas testing, and exposure monitoring examined contaminant exposure versus crossflow ventilation velocity. CFD modeling using the RNG k- turbulence model showed exposures to simulated methyl isobutyl ketone of 294 and 83.6 ppm, as a spatial average of five worker locations, for velocities of 0.508 and 0.381 m/s (100 and 75 fpm) respectively. In tracer gas experiments, observed supply/exhaust velocities of 0.706/0.503 m/s (136/99 fpm) were termed full-flow, and reduced velocities were termed 3/4-flow and half-flow. Half-flow showed higher tracer gas concentrations than 3/4-flow, which had the lowest time-averaged concentration, with difference in log means significant at the 95% confidence level. Half-flow compared to full-flow and 3/4-flow compared to full-flow showed no statistically significant difference. CFD modeling using these ventilation conditions agreed closely with the tracer results for the full-flow and 3/4-flow comparison, yet not for the 3/4-flow and half-flow comparison. Full-flow conditions at the painting facility produced a velocity of 0.528 m/s (104 fpm) midway between supply and exhaust locations, with the supply rate of 94.4 m3/s (200,000 cfm) exceeding the exhaust rate of 68.7 m3/s (146,000 cfm). Ventilation modifications to correct this imbalance created a mid-hangar velocity of 0.406 m/s (80.0 fpm). Personal exposure monitoring for two worker groups-sprayers and sprayer helpers ("hosemen")-compared process duration means for the two velocities. Hexavalent chromium (Cr[VI]) exposures were 500 vs. 360 microg/m3 for sprayers and 120 vs. 170 microg/m3 for hosemen, for 0.528 m/s (104 fpm) and 0.406 m/s (80.0 fpm) respectively. Hexamethylene diisocyanate (HDI) monomer means were 32.2 vs. 13.3 microg/m3 for sprayers and 3.99 vs. 8.42 microg/m3 for hosemen. Crossflow velocities affected exposures inconsistently, and local work zone velocities were much lower. Aircraft painting contaminant control is accomplished better with the unidirectional crossflow ventilation presented here than with other observed configurations. Exposure limit exceedances for this ideal condition reinforce continued use of personal protective equipment. |
Foodborne disease outbreaks in correctional institutions - United States, 1998-2014
Marlow MA , Luna-Gierke RE , Griffin PM , Vieira AR . Am J Public Health 2017 107 (7) e1-e7 OBJECTIVES: To present the first update on the epidemiology of US foodborne correctional institution outbreaks in 20 years. METHODS: We analyzed data from the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System to describe correctional institution outbreaks from 1998 to 2014 and compare them with other foodborne outbreaks. RESULTS: Two hundred foodborne outbreaks in correctional institutions were reported, resulting in 20 625 illnesses, 204 hospitalizations, and 5 deaths. Median number of outbreak-associated illnesses per 100 000 population per year was 45 (range = 11-141) compared with 7 (range = 4-10) for other outbreaks. These outbreaks accounted for 6% (20 625 of 358 330) of outbreak-associated foodborne illnesses. Thirty-seven states reported at least 1 outbreak in a correctional institution. Clostridium perfringens (28%; 36 of 128) was the most frequently reported single etiology. The most frequently reported contributing factor was food remaining at room temperature (37%; 28 of 76). CONCLUSIONS: Incarcerated persons suffer a disproportionate number of outbreak-associated foodborne illnesses. Better food safety oversight and regulation in correctional food services could decrease outbreaks. Public Health Implications. Public health officials, correctional officials, and food suppliers can work together for food safety. Clearer jurisdiction over regulation of correctional food services is needed. (Am J Public Health. Published online ahead of print May 18, 2017: e1-e7. doi:10.2105/AJPH.2017.303816). |
Notes from the Field: Knowledge, attitudes, and practices regarding yellow fever vaccination among men during an outbreak - Luanda, Angola, 2016
Marlow MA , Pambasange MA , Francisco C , Receado OD , Soares MJ , Silva S , Navarro-Colorado C , Zielinski-Gutierrez E . MMWR Morb Mortal Wkly Rep 2017 66 (4) 117-118 In January 2016, the Angola Ministry of Health reported an outbreak of yellow fever, a vaccine-preventable disease caused by a flavivirus transmitted through the bite of Aedes or Haemagogus species mosquitoes (1,2). Although endemic in rural areas of Angola, the last outbreak was in 1988 when 37 cases and 14 deaths were reported (3). Large yellow fever outbreaks occur when the virus is introduced by an infected person to an urban area with a high density of mosquitoes and a large, crowded population with little or no immunity (2). By May 8, a total of 2,267 suspected cases were reported nationally, of which 696 (31%) were laboratory confirmed; 293 (13%) persons died (4). Most (n = 445, 64%) confirmed cases lived in Luanda Province. As part of the public health response that included strengthened surveillance, vector control, case management, and social mobilization (1), mass vaccination campaigns were implemented in Luanda during February 2–April 16. Despite >90% administrative vaccination coverage (the number of vaccine doses administered divided by the most recent census estimates for the target population), the province continued to report cases (4). Field teams reported low numbers of men being vaccinated, which was a concern because of a preliminary analysis that indicated approximately 70% of confirmed yellow fever cases occurred in males. A rapid assessment to identify and address potential barriers to vaccination among men was designed, using a knowledge, attitudes, and practices survey. | During April 23–25, 2016, a knowledge, attitudes, and practices rapid assessment was administered to men at 10 sites in the four municipalities of Luanda with the greatest number of confirmed cases: Viana, Kilamba Kiaxi, Cacuaco, and Cazenga. The range for administrative vaccination coverage was 22%–137%. Survey sites included public transportation stops, public markets, main streets, and town squares. Interviewers consecutively sampled men of working age while walking in separate trajectories from the site center until the interviewers reached a target of 30 interviews. The questionnaire consisted of multiple choice and open-ended questions on demographics, disease knowledge, vaccination status, vaccination practices, and reasons for nonvaccination, as appropriate. |
Writing scientific articles like a native English speaker: concise writing for Portuguese speakers
Marlow MA . Clinics (Sao Paulo) 2016 71 (12) 684-686 As post-doctoral fellow in 2013, I published an editorial based on my experience as a translator, called “Writing scientific articles like a native English speaker: top ten tips for Portuguese speakers” (available at http://dx.doi.org/10.6061/clinics/2014(03)(01) 1. It focused on the repeated “simple” mistakes I observed while revising manuscripts of Brazilian friends and colleagues. I did not predict the editorial would receive as much attention as it did on social media. It speaks to Brazilian researchers’ quest for representation on the international scientific platform and the ever-growing number of Brazilian publications in international journals. | When I finished my post-doctoral fellowship, I left academia for government, starting a position as an Epidemic Intelligence Service (EIS) officer at the Centers for Disease Control and Prevention. Over the course of the two-year program, EIS officers learn applied public health by investigating outbreaks, making public health recommendations, and communicating public health issues to the public. The latter experience greatly changed my writing style. In the first month, I took a training called “Plain Language” developed by the National Institutes of Health (NIH). After applying the training to my communications as a public health official, I recognized my academic training prepared me to communicate my scientific findings to a scientific audience. Now my audience is the scientific community and the public. I was suddenly back on level one at a game I thought I had tirelessly conquered. Nevertheless, as with any skill, becoming a good writer is a matter of practice and persistence. |
Notes from the field: Botulism outbreak from drinking prison-made illicit alcohol in a federal correctional facility - Mississippi, June 2016
McCrickard L , Marlow M , Self JL , Watkins LF , Chatham-Stephens K , Anderson J , Hand S , Taylor K , Hanson J , Patrick K , Luquez C , Dykes J , Kalb SR , Hoyt K , Barr JR , Crawford T , Chambers A , Douthit B , Cox R , Craig M , Spurzem J , Doherty J , Allswede M , Byers P , Dobbs T . MMWR Morb Mortal Wkly Rep 2017 65 (52) 1491-1492 On June 9, 2016, the Mississippi Poison Control Center and the Mississippi State Department of Health (MSDH) notified CDC of five suspected cases of botulism, a potentially fatal neuroparalytic illness (1), in inmates at a medium-security federal correctional institution (prison A). By June 10, a total of 13 inmates were hospitalized, including 12 in Mississippi and one in Oklahoma (the inmate in Oklahoma had been transferred there after his exposure for reasons unrelated to his illness). MSDH, Oklahoma State Department of Health, Bureau of Prisons, and CDC conducted an investigation to identify the source and scope of the outbreak, and to develop recommendations. | Prison A staff members suspected that an alcoholic beverage, illicitly made by inmates and known as “hooch” or “pruno,” was the source of the outbreak. Among 33 inmates who reported consuming hooch during June 1–19, 2016, a total of 31 (94%) had signs or symptoms suggesting botulism. The median interval from first exposure to symptom onset was 3 days (range = 0–11 days) (Figure). Cases were categorized using modified Council of State and Territorial Epidemiologists definitions. A confirmed case was defined as an illness in an inmate consistent with botulism that began on or after June 1, with botulinum toxin type A detected in a serum or stool specimen or Clostridium botulinum cultured from a stool specimen; a probable case was defined as an illness in an inmate with signs or symptoms of any cranial nerve palsy and extremity weakness that began on or after June 1; and a suspected case was an illness in an inmate with signs or symptoms of any cranial nerve palsy without extremity weakness that began on or after June 1. |
Hexavalent chromium and isocyanate exposures during military aircraft painting under crossflow ventilation
Bennett JS , Marlow DA , Nourian F , Breay J , Hammond D . J Occup Environ Hyg 2015 13 (5) 1-50 Exposure control systems performance was investigated in an aircraft painting hangar. The ability of the ventilation system and respiratory protection program to limit worker exposures was examined through air sampling during painting of F/A-18C/D strike fighter aircraft, in four field surveys. Air velocities were measured across the supply filter, exhaust filter, and hangar midplane under crossflow ventilation. Air sampling conducted during painting process phases (wipe-down, primer spraying, and topcoat spraying) encompassed volatile organic compounds, total particulate matter, Cr[VI], metals, nitroethane, and hexamethylene diisocyanate, for two worker groups: sprayers and sprayer helpers ("hosemen"). One of six methyl ethyl ketone and two of six methyl isobutyl ketone samples exceeded the short term exposure limits of 300 and 75 ppm, with means 57 ppm and 63 ppm, respectively. All 12 Cr[VI] 8-hr time-weighted averages exceeded the recommended exposure limit of 1 microg/m3, 11 out of 12 exceeded the permissible exposure limit of 5 microg/m3, and 7 out of 12 exceeded the threshold limit value of 10 microg/m3, with means 38 microg/m3 for sprayers and 8.3 microg/m3 for hosemen. Hexamethylene diisocyanate means were 5.95 microg/m3 for sprayers and 0.645 microg/m3 for hosemen. Total reactive isocyanate group-the total of monomer and oligomer as NCO group mass-showed six of 15 personal samples exceeded the United Kingdom Health and Safety Executive workplace exposure limit of 20 microg/m3, with means 50.9 microg/m3 for sprayers and 7.29 microg/m3 for hosemen. Several exposure limits were exceeded, reinforcing continued use of personal protective equipment. The supply rate, 94.4 m3/s (200,000 cfm), produced a velocity of 8.58 m/s (157 fpm) at the supply filter, while the exhaust rate, 68.7 m3/s (146,000 cfm), drew 1.34 m/s (264 fpm) at the exhaust filter. Midway between supply and exhaust locations, the velocity was 0.528 m/s (104 fpm). Supply rate exceeding exhaust rate created re-circulations, turbulence, and fugitive emissions, while wasting energy. Smoke releases showing more effective ventilation here than in other aircraft painting facilities carries technical feasibility relevance. |
Performance of particulate containment at nanotechnology workplaces
Lo LM , Tsai CSJ , Dunn KH , Hammond D , Marlow D , Topmiller J , Ellenbecker M . J Nanopart Res 2015 17 435 The evaluation of engineering controls for the production or use of carbon nanotubes (CNTs) was investigated at two facilities. These control assessments are necessary to evaluate the current status of control performance and to develop proper control strategies for these workplaces. The control systems evaluated in these studies included ventilated enclosures, exterior hoods, and exhaust filtration systems. Activity-based monitoring with direct-reading instruments and filter sampling for microscopy analysis were used to evaluate the effectiveness of control measures at study sites. Our study results showed that weighing CNTs inside the biological safety cabinet can have a 37 % reduction on the particle concentration in the worker's breathing zone, and produce a 42 % lower area concentration outside the enclosure. The ventilated enclosures used to reduce fugitive emissions from the production furnaces exhibited good containment characteristics when closed, but they failed to contain emissions effectively when opened during product removal/harvesting. The exhaust filtration systems employed for exhausting these ventilated enclosures did not provide promised collection efficiencies for removing engineered nanomaterials from furnace exhaust. The exterior hoods were found to be a challenge for controlling emissions from machining nanocomposites: the downdraft hood effectively contained and removed particles released from the manual cutting process, but using the canopy hood for powered cutting of nanocomposites created 15-20 % higher ultrafine (<500 nm) particle concentrations at the source and at the worker's breathing zone. The microscopy analysis showed that CNTs can only be found at production sources but not at the worker breathing zones during the tasks monitored. |
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