Last data update: Jun 11, 2024. (Total: 46992 publications since 2009)
Records 1-10 (of 10 Records) |
Query Trace: Melnick N [original query] |
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Societal Costs of a Measles Outbreak
Pike J , Melnick A , Gastañaduy PA , Kay M , Harbison J , Leidner AJ , Rice S , Asato K , Schwartz L , DeBolt C . Pediatrics 2021 147 (4) BACKGROUND AND OBJECTIVES: Between December 31, 2018, and April 26, 2019, 72 confirmed cases of measles were identified in Clark County. Our objective was to estimate the economic burden of the measles outbreak from a societal perspective, including public health response costs as well as direct medical costs and productivity losses of affected individuals. METHODS: To estimate costs related to this outbreak from the societal perspective, 3 types of costs were collected or estimated: public health response (labor, material, and contractor costs used to contain the outbreak), direct medical (third party or patient out-of-pocket treatment costs of infected individuals), and productivity losses (costs of lost productivity due to illness, home isolation, quarantine, or informal caregiving). RESULTS: The overall societal cost of the 2019 Clark County measles outbreak was ∼$3.4 million ($47 479 per case or $814 per contact). The majority of the costs (∼$2.3 million) were incurred by the public health response to the outbreak, followed by productivity losses (∼$1.0 million) and direct medical costs (∼$76 000). CONCLUSIONS: Recent increases in incident measles cases in the United States and across the globe underscore the need to more fully understand the societal cost of measles cases and outbreaks and economic consequences of undervaccination. Our estimates can provide valuable inputs for policy makers and public health stakeholders as they consider budget determinations and the substantial value associated with increasing vaccine coverage and outbreak preparedness as well as the protection of society against vaccine-preventable diseases, such as measles, which are readily preventable with high vaccination coverage. |
Concordance between sites of tumor development in humans and in experimental animals for 111 agents that are carcinogenic to humans
Krewski D , Rice JM , Bird M , Milton B , Collins B , Lajoie P , Billard M , Grosse Y , Cogliano VJ , Caldwell JC , Rusyn II , Portier CJ , Melnick RL , Baan RA , Little J , Zielinski JM . J Toxicol Environ Health B Crit Rev 2019 22 203-236 Since the inception of the IARC Monographs Programme in the early 1970s, this Programme has developed 119 Monograph Volumes on more than 1000 agents for which there exists some evidence of cancer risk to humans. Of these, 120 agents were found to meet the criteria for classification as carcinogenic to humans (Group 1). Volume 100 of the IARC Monographs, compiled in 2008-2009 and published in 2012, provided a review and update of the 107 Group 1 agents identified as of 2009. These agents were divided into six broad categories: (I) pharmaceuticals; (II) biological agents; (III) arsenic, metals, fibers and dusts; (IV) radiation; (V) personal habits and indoor combustions; and (VI) chemical agents and related occupations. The Group I agents reviewed in Volume 100, as well as five additional Group 1 agents defined in subsequent Volumes of the Monographs, were used to assess the degree of concordance between sites where tumors originate in humans and experimental animals including mice, rats, hamsters, dogs, and non-human primates using an anatomically based tumor nomenclature system, representing 39 tumor sites and 14 organ and tissue systems. This evaluation identified 91 Group 1 agents with sufficient evidence (82 agents) or limited evidence (9 agents) of carcinogenicity in animals. The most common tumors observed in both humans and animals were those of the respiratory system including larynx, lung, and lower respiratory tract. In humans, respiratory system tumors were noted for 31 of the 111 distinct Group 1 carcinogens identified up to and including Volume 109 of the IARC Monographs, comprising predominantly 14 chemical agents and related occupations in category VI; seven arsenic, metals, fibers, and dusts in category III, and five personal habits and indoor combustions in category V. Subsequent to respiratory system tumors, those in lymphoid and hematopoietic tissues (26 agents), the urothelium (18 agents), and the upper aerodigestive tract (16 agents) were most often seen in humans, while tumors in digestive organs (19 agents), skin (18 agents), and connective tissues (17 agents) were frequently seen in animals. Exposures to radiation, particularly X- and gamma-radiation, and tobacco smoke were associated with tumors at multiple sites in humans. Although the IARC Monographs did not emphasize tumor site concordance between animals and humans, substantial concordance was detected for several organ and tissue systems, even under the stringent criteria for sufficient evidence of carcinogenicity used by IARC. Of the 60 agents for which at least one tumor site was identified in both humans and animals, 52 (87%) exhibited tumors in at least one of the same organ and tissue systems in humans and animals. It should be noted that some caution is needed in interpreting concordance at sites where sample size is particularly small. Although perfect (100%) concordance was noted for agents that induce tumors of the mesothelium, only two Group 1 agents that met the criteria for inclusion in the concordance analysis caused tumors at this site. Although the present analysis demonstrates good concordance between animals and humans for many, but not all, tumor sites, limitations of available data may result in underestimation of concordance. |
Notes from the Field: Community outbreak of measles - Clark County, Washington, 2018-2019
Carlson A , Riethman M , Gastanaduy P , Lee A , Leung J , Holshue M , DeBolt C , Melnick A . MMWR Morb Mortal Wkly Rep 2019 68 (19) 446-447 On December 31, 2018, Clark County Public Health (CCPH) in Washington was notified of a suspected case of measles in an unvaccinated child, aged 10 years, who had recently arrived from Ukraine. The patient was evaluated at an urgent care clinic for fever, cough, and a maculopapular rash. CCPH launched a case investigation, conducted contact tracing, and facilitated specimen collection and shipment to the Washington State Department of Health Public Health Laboratories. On January 3, 2019, measles virus was detected in the patient’s urine and nasopharyngeal specimens by reverse transcription–polymerase chain reaction (RT-PCR). By January 16, among 12 patients with suspected measles reported to CCPH during January 11–14, all had laboratory-confirmed measles by RT-PCR. In response to these confirmed cases and additional suspected cases, CCPH’s Incident Management Team was activated on January 15. Approximately 200 persons participated in the multiagency response, which included CCPH, the Washington State Department of Health, and CDC. As of March 28, 2019, measles had been confirmed among 71 Clark County residents, with rash onsets from December 30, 2018, to March 13, 2019. |
Impact of rotavirus vaccine introduction and vaccine effectiveness in the Republic of Moldova
Gheorghita S , Birca L , Donos A , Wasley A , Birca I , Cojocaru R , Melnick A , Ciobanu S , Mosina L , Cortese MM , Parashar UD , Lopman B . Clin Infect Dis 2016 62 S140-S146 Background. The Republic of Moldova was the first low- to middle-income country in the World Health Organization European Region to introduce rotavirus vaccine (July 2012). We aimed to assess the impact of the rotavirus vaccine program and estimate vaccine effectiveness (VE). Methods. Surveillance for rotavirus gastroenteritis was conducted in 2 hospitals in the capital city of Chisinau starting in September 2009. Monthly rotavirus admissions by age were examined before and after introduction of rotavirus vaccination using interrupted time-series analyses. We performed a case-control study of VE by comparing rotavirus case patients with test-negative controls. Results. Coverage with at least 1 dose of vaccine increased from 35% in year 1 to 55% in year 2 for children <1 year of age. The percentage of hospital admissions positive for rotavirus fell from 45% in the prevaccine period to 25% (rate reduction, 36%; 95% confidence interval [CI], 26%-44%) and 14% (rate reduction, 67%; 95% CI, 48%-88%) in the first and second years after vaccine introduction, respectively, among children aged <5 years. Reductions were most pronounced among those aged <1 year. Significant reductions among cohorts too old to be vaccinated suggest indirect benefits. Two-dose VE was 79% (95% CI, 62%-88%) against rotavirus hospitalization and 84% (95% CI, 64%-93%) against moderate to severe rotavirus. Conclusions. These results consistently point to profound direct and herd immunity impacts of the rotavirus vaccine program in young children in the Republic of Moldova. Vaccine coverage was modest in these early years following introduction, so there remains potential for further disease reductions. |
An epidemiologic investigation of occupational transmission of Mycobacterium tuberculosis infection to dental health care personnel: infection prevention and control implications
Merte JL , Kroll CM , Collins AS , Melnick AL . J Am Dent Assoc 2014 145 (5) 464-471 BACKGROUND: The authors describe an investigation of a dental hygienist who developed active pulmonary tuberculosis (TB), worked for several months while infectious and likely transmitted Mycobacterium tuberculosis in a dental setting in Washington state. METHODS: Clark County Public Health (CCPH) conducted an epidemiologic investigation of 20 potentially exposed close contacts and 734 direct-care dental patients in 2010. RESULTS: Of 20 close contacts, one family member and two coworkers, all of whom were from countries in which TB is endemic, had latent TB infection (LTBI). One U.S.-born coworker experienced a tuberculin skin test (TST) conversion from 0 to 8 millimeters. Of the 305 of 731 (41.7 percent) potentially exposed patients who received a single TST, 23 (7.5 percent) had a positive TST result of at least 5 mm. Among the subset of 157 patients tested by CCPH staff, 16 (10.2 percent) had a positive TST result. The dental office did not have infection prevention and control policies related to TB identification, prevention or education. CONCLUSIONS: The coworker's TST conversion indicated a recent infection, likely owed to occupational transmission. The proportion of dental patients with positive TST results was greater than the 1999-2000 National Health and Nutrition Examination Survey prevalence estimate in the general population, and it may reflect transmission from the hygienist with active TB or a prevalence of LTBI in the community. Practical Implications All dental practices should implement administrative procedures for TB identification and control as described in this article, even if none of their patients are known to have TB. |
A gel-free proteomic-based method for the characterization of Bordetella pertussis clinical isolates
Williamson YM , Moura H , Simmons K , Whitmon J , Melnick N , Rees J , Woolfitt A , Schieltz DM , Tondella ML , Ades E , Sampson J , Carlone G , Barr JR . J Microbiol Methods 2012 90 (2) 119-33 ![]() Bordetella pertussis (Bp) is the etiologic agent of pertussis or whooping cough, a highly contagious respiratory disease occurring primarily in infants and young children. Although vaccine preventable, pertussis cases have increased over the years leading researchers to re-evaluate vaccine control strategies. Since bacterial outer membrane proteins, comprising the surfaceome, often play roles in pathogenesis and antibody-mediated immunity, three recent Bp circulating isolates were examined using proteomics to identify any potential changes in surface protein expression. Fractions enriched for outer membrane proteins were digested with trypsin and the peptides analyzed by nano liquid chromatography-electrospray ionization-mass spectrometry (nLC-ESI-MS), followed by database analysis to elucidate the surfaceomes of our three Bp isolates. Furthermore, a less labor intensive non-gel based antibody affinity capture technology in conjunction with MS was employed to assess each Bp strains' immunogenic outer membrane proteins. This novel technique is generally applicable allowing for the identification of immunogenic surface expressed proteins on pertussis and other pathogenic bacteria. |
A rapid method for capture and identification of immunogenic proteins in Bordetella pertussis enriched membranes fractions: a fast-track strategy applicable to other microorganisms
West R , Whitmon J , Williamson YM , Moura H , Nelson M , Melnick N , Tondella ML , Schieltz D , Rees J , Woolfitt AR , Barr JR , Ades EW , Carlone GM , Sampson JS . J Proteomics 2012 75 (6) 1966-72 ![]() Mass spectrometry (MS) coupled with 1-D and 2-D electrophoresis can be utilized to detect and identify immunogenic proteins, but these methods are laborious and time-consuming. We describe an alternative, simple, rapid gel-free strategy to identify multiple immunogenic proteins from Bordetella pertussis (Bp). It couples immunoprecipitation to nano liquid chromatography- tandem mass spectrometry (IP-nLC-MS/MS) and is significantly both time- and labor-saving. We developed a gel-free magnetic bead-based immunoprecipitation (IP) method using different NP-40/PBS concentrations in which solubilized proteins of Bp Tohama I membrane fractions were precipitated with polyclonal rabbit anti-Bp whole cell immune sera. Immune complexes were analyzed by MS and Scaffold analysis (>95% protein identification probability). Total immunoproteins identified were 50, 63 and 49 for 0.90%, 0.45% and 0.22% NP-40/PBS buffer concentrations respectively. Known Bp proteins identified included pertactin, serotype 2 fimbrial subunit and filamentous hemagglutinin. As proof of concept that this gel-free protein immunoprecipitation method enabled the capture of multiple immunogenic proteins, IP samples were also analyzed by SDS-PAGE and immunoblotting. Bypassing gels and subjecting immunoprecipitated proteins directly to MS is a simple and rapid antigen identification method with relatively high throughput. IP-nLC-MS/MS provides a novel alternative approach for current methods used for the identification of immunogenic proteins. |
P4 peptide therapy rescues aged mice from fatal pneumococcal sepsis
Rajam G , Bangert M , Hammons GM , Melnick N , Carlone GM , Sampson JS , Ades EW . Clin Vaccine Immunol 2010 17 (11) 1823-4 Many studies suggest that with aging, immune capabilities gradually diminish, leading to a decrease in antibody production, cytokines, and various effector cells (1-4). In this study, we examined the effects of an immune-enhancing peptide on aged mice. P4, a 28-amino-acid cationic peptide derived from pneumococcal surface adhesin A (PsaA), is a eukaryotic cellular activator (10). Previously, we demonstrated that the cellular activation properties of P4 can be utilized to rescue severely ill young mice from fatal pneumococcal infection in the presence of pathogen-specific antibodies and active complement (8, 12). While P4 therapy was used to rescue young Swiss Webster mice (6 to 10 weeks old), we questioned its effectiveness in aged mice (11 and 15 months old). | Intranasal inoculation of mice with Streptococcus pneumoniae WU2 (serotype 3) and P4 therapy were done using protocols previously described, with minor modifications (12). Eleven-month-old BALB/c (n = 20) and 15-month-old Swiss Webster mice (n = 20) were infected intranasally with S. pneumoniae WU2 (∼2.1 × 107 cells/mouse). Mice were monitored and visually scored twice daily for moribund characteristics as previously described (12). At 48 h postchallenge, 80% (16/20) were moribund. Moribund mice were divided into a control (n = 8) and a treatment group (n = 8). Two doses of P4 therapy with pathogen-specific antibody (intravenous immunoglobulin [IVIG]; Gamunex, Telecris, NC) and P4 were administered intravenously (postinfection) in the treatment group. Treated and untreated animals were monitored for 166 h, and the data computed for significant differences among various groups using a t test for paired samples for the means (MS Excel 2007). |
Serotype specific antisera for pneumococcal serogroup 6 serotypes 6A, 6B and 6C
Melnick N , Thompson TA , Beall BW . J Clin Microbiol 2010 48 (6) 2311-2 Streptococcus pneumoniae strains can express one of at least 92 capsular serotypes. To our knowledge, our laboratory is one of two that maintain antisera for resolution of the first 90 discovered pneumococcal serotypes (4; unpublished data). Recently, the evaluation of serogroup 6 isolates using monoclonal antibodies led to the discovery of the 91st serotype, 6C (7), which has become the prevalent invasive serogroup 6 serotype within the United States (2, 9). The pneumococcal 7-valent conjugate vaccine (PCV7) does not protect against it, and it is not included within the newly licensed 13-valent conjugate vaccine. In addition, serotype 6C carriage may also be common within PCV7-vaccinated populations (3). Prior to the discovery of serotype 6C, serotypes 6A and 6B were the 2 known serogroup 6 serotypes. CDC antisera for quellung-based resolution of serotypes 6A and 6B are designated as Danish factors 6b and 6c (DF-6b and DF-6c), respectively. Our original DF-6b antiserum was positive for both 6A and 6C serotypes, preventing their resolution (Table (Table11). |
A national public health agenda for osteoarthritis 2010
Lubar D , White PH , Callahan LF , Chang RW , Helmick CG , Lappin DR , Melnick A , Moskowitz RW , Odom E , Sacks J , Toal SB , Waterman MB . Semin Arthritis Rheum 2010 39 (5) 323-6 Arthritis is the most common cause of disability, and osteoarthritis is our nation's most common form of arthritis. This serious, painful and potentially life-altering joint disease places severe limits on daily activity and quality of life for over 27 million Americans. Affecting mainly hands, knees and hips, osteoarthritis (OA) often causes weakness and disability, interferes with work productivity, results in joint replacement and generates inordinate socioeconomic costs. In view of the fact that the U.S. population is aging and obesity is on the rise, the prevalence, health impact and economic consequences of OA are expected to increase dramatically. | Now is the time for bold and innovative action to reduce the burden of this growing public health issue. The National Public Health Agenda for Osteoarthritis sets the stage for a collaborative and focused initiative to achieve three overall goals over the next three to five years: | • | Ensure the availability of evidence-based intervention strategies—such as self management education, physical activity, injury prevention, and weight management and healthy nutrition—to all Americans with OA | • | Establish supportive policies, communication initiatives and strategic alliances for OA prevention and management | • | Initiate needed research to better understand the burden of OA, its risk factors and effective strategies for intervention. | | Leadership from the Centers for Disease Control and Prevention (CDC) and the Arthritis Foundation (AF) initiated a collaboration to address ways to reduce the public health burden of osteoarthritis. This collaboration led to the creation of The National Public Health Agenda for Osteoarthritis. This document is an executive summary of the report; the complete report can be found on our journal's website (http://semarthritisrheumatism.com), the AF's website (http://www.arthritis.org/osteoarthritis-agenda.php), and the CDC's website (www.cdc.gov/arthritis/docs/OAagenda.pdf). |
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